Skip to main content

Full text of "Alienist and neurologist."

See other formats


Columbia (Bnfttnttp 

College of iPfjpgtriang anb burgeons; 
Hibrarp 




a 




"Quantam ego quidem video motus morbosi fere omnes a motibus in systemate nervorum ita 
pendent ut morbi fere omnes quodammodo Nervosi dici queant."— Cullen's NOSOLOGY: BOOK II, 
P, 181-EDINBURG Ed., 1780. 



Scientific, Clinical and Forensic 

NEUROLOGY AND PSYCHOLOGY, 

PSYCHIATRY AND NEURIATRY. 



Intended Especially to Subserve the Wants of the 
General Practitioner of Medicine. 



the: 




A JOURNAL OF 



VOLUME xxvm. 



CHARLES H. HUGHES, M. D., Editor. 
MARC RAY HUGHES, M. D., Associate Editor. 



HENRY L. HUGHES, Manager and Publisher. 



3872 Washington Boul., ST. LOUIS, MO. 
1907, 



CONTRIBUTORS AND COLLABORATORS. 
TO VOLUME XXVIII. 



HARRIET C. B. ALEXANDER, 

Chicago. 

ALBERT S. ASHMEAD, 

New York. 



JOSEPH COLLINS, 



New York. 



EDWIN G. ZABRISK1E, 

New York. 



G. F. ADAMS, 



Kenosha, Wis, 



R. W. SHUFELDT, 



New York, 



HAROLD N. MOYER, 



Chicago, 



HAVELOCK ELLIS, 

Cornwall, Eng. 



JAS. G. KIERNAN, 



DR. GIERLICH, 



Chicago. 



Weisbaden 



THEODORE SCHROEDER, 

New York, 

WHARTON SINKLER, 

Philadelphia, 



C. H. HUGHES, 



St. Louis 



Index. 



iii 



INDEX. 



ORIGINAL CONTRIBUTIONS. 



Icohol in Therapeutics 72 

Psychological Medico-Legal Study 168 
Mistaken Diagnosis of Dementia 

Senilis 464 

ise of Canine Hermaphrodism. . . . 189 

rotic Symbolism 18 

rotism (Normal and Morbid) and 
the Unwritten Law in Our 

Courts 205 

rotogenesis of Religion 330 

rotism (Normal and Morbid) and 
the Unwritten Law in Our 

Courts 378 

ectrical Sleep 443 

Dmo-Sexual Complexion Perverts 

in St. Louis 487 

Genius a Sport, A Neurosis, or a 

Child Potentiality Developed? 139 
Sexual Perversion Insanity?.... 193 
mrones in the Light of our Pres- 
ent Knowledge 34 

ychological Studies of Man's Mor- 
al Evolution 177 

riodical Paranoia and the Origin 
of Paranoiac Delusions 303 



Psychological Studies of Man's 

Moral Evolution 367 

Recurrent Functional as Distin- 
guished from the Typical Or- 
ganic Dementia Senilis of the 
Literature 81 

Some Psychological Studies of 

Man's Moral Evolution 1 

Some Psychological Studies on 

Man's Moral Evolution 449 

The Tramp as a Social Morbidity. . 157 

The Entoning of the Neurones 
in the Practice of Medicine and 
Surgery 164 

Thaw's Paranoiac Morbid Egoism. .224 

The Relation of Cerebro-Spinal 

Fluid to Epilepsy 342 

The Alienist on the Witness Stand. 
Unscientific Ruling of the Court 
in the Thaw Case. Fallacy of 
the Legal "Knowledge of Right 
and Wrong Test of Insanity," 
etc 346 

The Growth of Neurology 484 



IV 



Index , 



EDITORIALS. 



An Illustration of Psychokinesia. . . 90 

A Psychic Block System for Rail- 
roads 95 

A Righteous Judgment 97 

Appeal by Edward S. Morse 98 

Adequate Timely Sleep for the Nor- 
mal Mind 102 

An Alcoholic Drunk Theft Obses- 
sion 106 

All Night and Eight Hour Labor 

Shifts for the Canal Zone 100 

An Android Woman Homosexually 

Conjugally Mated 108 

A Psychic Spasm of Unwritten Law 

Homicide 110 

Acknowledgment of Invitation.. . . 110 

A Strange Proceeding 234 

Apropos of H. K. Thaw 236 

A Rational and Villainous Brain 

Storm 237 

An Over Brain Strained Signal 

Man became Insane 241 

An Extremely Young Girl Suicide 248 
A Rare Note of Thankful Obligation 

From a Rare Attorney 258 

A Rigid and Right Investiga- 
tion 260 

A Just Court Decision. Hot Water 
in Ear is "External" Injury, 

Rules the Court 262 

American Editors Association 262 

A Victim of Bromidia Self-Medica- 
tion Folly . 400 

A Rhapsody on Exody 400 

A Deadly Lively 407 

Antivivisection Defeat — Thanks to 

Dr. S. Weir Mitchell 411 

A Pitiable Cocaine Slave 411 

A Would-be Patricide of St. Louis 417 
A Bee Sting Causing Fatal Tetanus 418 



A Vision at the Vatican 

A Deluded Christopath 

A Peculiar Display of Psychic Ep- 
ilepsy 

A Relapse to Barbarism 

A Case of Folie Raisonante — Com- 
mitting a Sane Man to an Asy- 
lum 

An Eastern Rabbi 

A Cruelty Working Law 

Aged Authors, the Temperate Life 
and Louis Cornaro 

Another Insane Stabber 

Alexander Smith 

A New Journal 

A Street Car Roadside Illusion and 
Delusion 

American Superlatives and Dr. Men- 
del 

Beverly Farm School 

"Brain Storms, the 'Exaggerated 
Ego,' A Layman's View.". . . . 

Brutal Vivisection by a Brutal Med- 
ical Student 

Barnes Medical College 

" Baffling to Medical Science" 

Correspondence — Feinting, Faint- 
ing Bertha 

Condition of Cuban Insane Asylum 

Chronology of Dowie and Zion 
City 

Christian Science has a Rival 

Criticism of the Rulings of Judge 
Fitzgerald 

Chorea Considered as a Neurohu- 
moral Disorder 

Cruel and Absurd Treatment 

Dr. Bund, the President Elect of 
the A. M. A 

Dr. C. C. Wiley 



418 
418 

421 
422 



424 
494 1 
501 

503 
505 
50'.) 
511 

511 



512 1 
10911 

244 I 



499 
501 

501 

261 
106 

23S 



lo: 

2541 
I I :> 

50( 
991 



! 



Index. 



V 



Dr. James L. Greene 110 

il Death of R. Harvey Reed of Wy- 

j oming 236 

Dr. Clarence Martin 248 

Dr. Perry on the Pathology of Dia- 

■ betes 251 

Dr. Herman A. Sante 262 



Dr. Kuhn 418 

[Depressive Insanity 495 

Dr. Edward K. Taylor 514 

Dr. Albert Warren Ferris 514 

Dr. Julius Grinker 514 

etiology of Speed Mania 101 

Evelyn Thaw and Her Drugged 

Drink 246 

2rotically Inspired or Erotopath- 

ically Impelled Virtue and Vice 505 
failure to Recognize Nervous Influ- 
ence in Hand- Writing 416 

iedonic Erotopathic Perversion . . 513 

hysterical Monopalsies 107 

hysterical Stigmata in Court 251 

in Line With the Address of Victor 

Horsely 104 

it is Unfair to the Insane 235 

it is Unfair to an Insane Person. . . 235 
in Insanity, Appearances are De- 
ceptive 235 

inadequately Qualified Psycholog- 
ical Experts 242 

insanity is a Disease 243 

international Congress on Psychia- 
try, Neurology and Psychology 252 
nsanity and Responsibility 409 

improved Health Conditions on the 

Panama Canal Zone 410 

is it an Evidence of Psychic De- 
cadence ? 509 

fohn Alexander Dowie 238 

judicial Misconception and Wrong 
Definition of a Wound and of 
Insanity 414 



Kuroki and Gages Skull 402 

Kraepelin's Critic, Dreyfus 494 

Lombroso and Thaw. .- 96 

' ' Legislative Schemes of The Amer- 
ican Medical Association.''. . . 104 
Lord Rosebery's Brilliant Idea of 
the Cause of the Increase of 

Insanity 108 

Life Sacrifice of a Surgeon and Phy- 
sician 502 

Lay Appreciation of Physicians.. . . 508 
Lithium is a Degradation from 

Copper 513 

Labor's Right to Rest 417 

Minimum and Non-Alcohol Pre- 
scribing 256 

Making Steel and Killing Men 511 

Mendel, Sansom, Hitzig, Steffani, 
Foster, Broadbent and At- 

water 514 

Now it is the President 216 

Night Medical School not Satisfac- 
tory to State Board 493 

Noah Webster as a Spelling Re- 
former 504 

Numerical Race Suicide 508 

New Phase of Psychological Expert 

Testimony 514 

Our Proprietary Pharmaceutical 

Allies 103 

Ohio Insane Asylum Ex-Employes 

Indicted 239 

One of Those Erotopathic Women 245 
Opium-Bromid Treatment of Ep- 
ilepsy 247 

Overcrowding in Hospital for the 

Insane 498 

Placebo Philosophers and the Bis- 
marck Archipeligo Experiment 92 

Physiology and the Physician 93 

Psychic Sanitary Sense Coming to 

the Senate 100 



Police Euthanasia in San Francisco. 110 

Pyrophiles and Pyrophobes 233 

aranoiac, Pyromaniac and Hom- 
icide 233 

Po Old Dr. Dowie 240 

Public Recognition of Medical Men 258 
Promoting the Unstable and Con- 
serving the Stable Neurone . . . 422 

Poliomyelitis Anterior 496 

Quinine as a Defense of Crime 110 

Refusing Epileptics Table Salt. . . . 248 

Right, Mr. Times 410 

Recuperation From Cerebrospinal 

Meningitis 502 

' ' Sight Unsen ' ' Lawyer and Doc- 
tor Choosing 105 

Shall State go Backward with its 

Insane? 406 

Sometimes in Our Social Life 419 

Sclerosed Blood Vessels (New View) 420 

Suicide Pacts 423 

State Fair — New Features 424 

Stuttering Treatment According 

to Scripture 495 

Some Alienist Medical Opinion. . . . 502 
Sajous Says the Source of the Op- 
sonins 510 

The Alienist and Neurologist. 90 

The Professional Endeavor 101 

The Aching Tooth and the Motor- 
man 107 

The Name of the Journal 108 

The Study of Mental Diseases 109 

The Life Courteous 109 

To Awaken Every Psychic Neurone 109 

Two Insane Fratricides in One 

Family Ill 

The Unqualified Exaggerated Ego. 230 

The Journal of Inebriety 232 

The St. Louis Alamagordo Tuber- 
culosis Sanatorium 233 



There May be Grave But Masked 

Delusion 235 

Toxic Insanoid States and Delirium 

With Consciousness 240 

The Strenuous Unrestful Life 241 

The Farcical Trial 243 

The Paratereseomaniac 245 

The Spread of the Impulsive In- 
sanity Idea 246 

The Tetanic and Septic Dangers of 

Gelatin 248 

The Childs Physiological Magna 

Charta 249 

The Public Conscience 250 

The Unstable Psychic Neurone. . . . 250 

Thaw's Insanoid Morbid Egoism ... 255 
The 16th International Medical 

Congress 256 

The Cinemetograph Demonstration 257 
The Blood Pressure in Cases of Par- 
etic Dementia 259 

16,937 Railway Casualties 260 

The Calingas of Luzon 401 

The Insanity of King Otto 401 

The Purposes of the Public Health 

Defense League 402 

The St. Louis Censor and the Thaw 

Trial 408 

The Time is Now Propitious 413 

The Nudity Fad 414 

The Unstable Neurone at Blees 

Academy 419 

The Farmer's Wife and Insanity. . 419 

The Arizona Man- Woman 421 

The Death of Theodore Tilton 422 

The Weekly Medical Review 424 

The American Association for the 

Study of the Feeble Minded . . 425 

The Amsterdam Congress 894 

The Twenty-Ninth Year 493 

The New Science-Eugenics 496 



Index. 



vii 



The Million Mark 496 

The Last Almshouse Lunatic 496 

Therapeutically Enjoined Self- 
Denial 496 

[The Cocaine Fiend 497 

[The Health Rights of the Citizen 501 
IThe Egoism of the Insane 504 

[The Nervous System and Diabetes 

Was Pavy's 506 

IN MI 

[Alexander E. Macdonald 115 

[Dr. A. V. L. Brokaw 112 

Dr. Alonzo Garcelon 114 

MDr. William James Herdman 114 



ShLEC 

Clinical Neurology — 

Chorea 119 

double Consciousness Before the 
American Neurological Asso- 
ciation 117 

"uvenile Albuminuria 270 

Nervous Phenomena During Pass- 
age of Chyme Through Pylorus 267 

babies 120 

^are Affection of the Pyramidal 



Tract With Spastic Spinal Paral- 
ysis and Bulbar Symptoms.. . . 527 

A he Pathogenesis of Facial Hemi- 
atrophy 268 

The Insanity of Inebriety 269 

The Tarsophalangeal Reflex 526 

Three Cases of Lingual Neuralgia. . . 528 

Clinical Psychiatry — 

Emotional Control of Japanese 

Women 525 

leeting of N. Y. Hospital Physi- 
cians for the Insane 524 

Neurophysiology — 

'ause of Soft-Shelled Eggs 431 

Neuropathology — 

:5rain Tumor 529 



The Alternating Insane Automat- 
ism of Suddenly Suppressed 
Epilepsy 507 

The Testimony of a Woman 510 

Two Hoboken Doctors 510 

The Force of Mind in Medicine. ... 511 

The Fiction Serial 515 

'OR/AM. 

Death of Theodore Buhl 263 

Dr. A. E. Sansom 516 

Dr. F. V. L. Brokaw 516 

The Death of John F. Magner 113 

T/ONS. 

The Microbe of Poliomyelitis 529 

Neurotherapy — 

Alcohol in Diabetes 277 

Biers Congestion Treatment 522 

Dionin 274 

Dr. Hawkins 277 

Extensive Lumbar Anesthesia. ... 521 
For the Last Few Years Pharma- 
cists and Physicians 517 

Further Experience With Opsonins 273 
High Intensity Galvanic Current 

in Trigeminal Neuralgia 518 

Loaf Sugar in Diabetes 523 

On Sedative and Hypnotic Therapy 520 
Pharmacological Properties of Syn- 
thetic Suprarenin (Adrenalin) 519 
Spinal Anaesthesia in Tetanus 518 

The Treatment of Noises in the Ear 

Upon a Diet Free from Salt. . 275 

Veronal in Tremor 432 

Neurosurgery — 

Some Mental Symptoms due to 
Disease of Nasal Accessory 
Sinuses 281 



viii 



Index. 



Surgical Treatment of Paralysis. 
Psychiatry — 

Potomania in a Child 

Xeuroophthalmy — 

The Tenotomomaniac 

Xeurosemiopathy — 

Abortion as a Cause of Tetanus. . . 



.524 



271 



H.-EMOXEUROTHERAPY 

Opsonic Therapy 2' 

Neurovascular Pathology — 
Haemotoxic Etiology of Atheroma 

and Arteriosclerosis 4J 

Senator on the Causes of Arterio- 
sclerosis 4! 

Xeurohematology — 
Blood in Asthmatics 



4:11 



REVIEWS, BOOK NOTICES, ETC, 



A Study of the Motor Phenomena 

in Chorea 123 

An Illustrated Announcement 128 

Advancing St. Louis Art Value in 

Developing a City 538 

Anatomy of the Brain and Spinal 

Cord 539 

A Brief Sketch 540 

A Plea for the More Energetic 

Treatment of the Insane 541 

Anales Del Cuarto Congreso Medico 

Pan- Americano 542 

Conservative Gynecology and Elec- 
tro-Therapeutics 127 

Clinical Psychiatry 434 

Dictionaire de Medicine et de Thera- 
peutique Medicale et Chirur- 

gicale 531 

Diseases of the Rectum, their Con- 
sequences and Non-Surgical 

Treatment 537 

Folia Therapeutica 434 

Historic Notes of Canadian Med- 
ical Lore and Lecture Mem- 
oranda 126 

Humanity 128 

Internal Secretions and the Princi- 
ples of Medicine 532 

International Congress 537 

L'Aime et le Systeme Xerveux ... 531 

Nervous and Mental Diseases 130 

Xeurographs, a Series of Neurolog- 
ical Studies, Cases and Notes 283 

Paton 537 

Public Health 538 

Patons' Psychiatry 285 

Preliminary Medical Education. . . . 530 
Recollections of a Gold Cure Grad- 
uate 125 



Rhythmotherapy 

Saunders Complete Catalogue 

Starr on Nervous Diseases 

State of New York 

The Christian Register 

Text Book of Psychiatry 

The. St. Louis Courier of Medicine 

The National Geographic Magazine 

The Hesperian 

The Spectator 

The Program of the Fourth Annual 
Meeting jDf the Philippine Is- 
lands Medical Association .... 

The Open Air Treatment in Psy- 
chiatry 

The N. Y. State Commission in 
Lunacy 

Text Book of Psychiatry. — A Psy- 
chological Study of Insanity 
for Practitioners and Students 

The Subconscious 

The Nervous System of the Verte- 
brates 

The Diseases of the Rectum 

The Proceedings 

The Diagnosis of the Nervous Sys- 
tem 

The Asylum News 

The Nervous System of Vertebrates 

The Nature and Treatment of Pter- 
ygia s 

"The Hospital" 

The Integrative Action of the Ner- 
vous System 

Woman 

W. B. Saunders Company 

Wellcome's Photographic Exposure 
Record 



124 

126 
126 
127 
127 



!83 



:>4 



THE 

ALIENIST AND NEUROLOGIST 



VOL. XXVIII. ST. LOUIS, FEBRUARY, 1907. No. 1. 

SOME PSYCHOLOGICAL STUDIES OF MAN'S 
MORAL EVOLUTION. 

By ALBERT S. ASHMEAD, M. D., 

New York. 



L 

THE MYSTERY OF OUR KNOWLEDGE OF GOOD AND EVIL— ITS 
ZENITH AND ITS NADIR.* 

'TPHE occult power of evil is remembered also in an in- 
• cident I h ave before related, of the breaking of a 
goblet by a little black imp, seen only by the mother of an 
absent child. This mother was lying on her couch and 
the goblet was upon a table. She saw the black elf, stand- 
ing on the table beside the goblet, raise a hammer as if to 
strike the goblet rim. She cried out, "He is going to break 
it;" "He will break it;" "He has broken it." And it fell 
in a thousand pieces to the floor. 

At that very moment the breath of her dearly beloved 
child had left its body, in a distant city. 

I recall also the story of the voice which a gentleman 
heard, who was traveling eastward from San Francisco. 
It commanded him to "Go back." Finally by its persist- 
ing, on going to the baggage car, at some stopping station, 
where he had determined to obey the strange command, and 

*Continued from November, 1906. 



2 



Albert S. Ashmead. 



where he supposed he would meet with much trouble to 
find his trunk among the multitudinous baggage, he found 
the baggage car door open and the baggage master with his 
identical trunk awaiting him. The baggage man stood there, 
with his hand resting on his trunk ready to pass it out to 
him. Upon his return to San Francisco, by the back bound 
train which passed the station where he got off a few min- 
utes after he had left the east bound train, he found his old 
father breathing his last. He lived but two hours after 
his son's return. 

"Ah!" says the Fatalist or the Occultist, "I have 
neither faith nor reverence. There is no Free-will. We are 
all helpless." It is worthy of note here that the advance of hu- 
man insight into natural law is accompanied by the cast of 
thought indicated by the Buddhist's belief in Nirvana. 

The occult must be approached by the path of Reason. 

All that happened to Dr. Love for instance, is happen- 
ing daily to everybody. On the doctrine of chances, could 
there have been a concentration upon his family? or, was 
there a Direction, an Intention? 

Another case, that of a Dr. Patterson, is likewise here 
pertinent, and directly in line with the theory of involun- 
tarism; and the review of this case by the alienist, Dr. Mc- 
Guire, shows in mentality, all the mind phenomena; the 
same simulation, dissimulation, and later determination, that 
Nature exhibits in bodily ills that our medical profession 
devotes itself to studying. Dr. Patterson, of Colorado, 
gloried in his criminality. "When a child," he says, "I 
felt the influence of heredity, felt that I was born to be a 
thief." "It is necessary," he says further, "for society to 
protect itself against men of my class." 

I agree with him, and I also believe that he states the 
truth as to his feelings. Society must protect itself against 
lunatics, without conscience and without remorse. But are 
these beings really lunatics because evil, as we know it, has 
obtained possession of their bodies, brains and other cells? 

For years a careful student of criminology, taking the 
deepest interest in the study, because he recognized in 
himself the proof of the theory that a criminal is what he 



Man's Moral Evolution. 



3 



.s because he is born with instincts, the development of 
which neither environment, fear of punishment, social os- 
tracism nor anything else can prevent, this Dr. Patterson, 
now confined in a cell in the jail at Denver, was arrested 
on a charge of forgery. In his early years he fought against 
his inherent desire to take what belonged to his fellow man, 
because of the disgrace that he feared his father, mother, 
and other loved ones would suffer from his actions, and for 
the sake of his wife and children, he continued to wage the 
unequal battle. It was heredity versus environment, he de- 
clares, and heredity won. 

This is the excuse he gives for his present condition. 
From a man of prominence and an heir to great wealth, 
the police found that his fall was so complete that he was 
living in the most abject poverty in a dingy room in the 
lowest quarter of the city. 

"My one great regret in life," he says, "is that I have 
fallen a slave to the morphine habit and, unable to resist 
its use, have failed in my ambition to become the greatest 
criminal of the age." 

"1 glory in crime and am a criminal because it is im- 
possible for me to be anything else. I have tried and failed, 
and am glad of it. The fight was unequal at best, and I 
am glad that I finally started out in a career of crime and 
that I have committed thefts and burglaries, have stolen 
into houses at night time and taken property that belonged 
to others, for the pure love of it. 

"I did not need the money, did not want the booty 
that I took away after I got it, but there was a satisfaction 
too deep for words, too self-satisfying for explanation. I 
imagine that a woman who has held her lover at arm's 
length and perhaps for the best of reasons, has refused to 
surrender to him for a long time, must feel much as I did 
when I committed my first theft. It was not much, too 
little a thing to notice, yet it was the beginning of a career 
that I mapped out for myself after I fully realized that 
there was nothing in the world that could prevent my be- 
ing anything but a thief. I was in a fellow physician's 
office and 1 saw a pocket book lying on the table. He was 



4 



Albert S. Ashmead. 



busy with a patient and I opened the wallet and found two 
dollars in it. I then had plenty of money and the contents 
of the purse could do me little good, but resist the desire 
to take the money I could not and did not. I knew that the 
high character I bore would protect me from the possibility 
of exposure, and the cunning, which I have since learned 
and which I use to protect me from being found out when 
I succumbed to my desire to take possession of that which 
does not belong to me, was not necessary in that case. 
That was years ago, how many I do not know. It was 
the beginning. 

4 'My father and mother were of the highest character. 
The desire which impelled me to take the marbles of other 
little boys, to filch the pockets of my school-mates, when 
their coats hung in the coat-room, came from further back 
than my immediate ancestors, just as the genius of a great 
painter, or that of a great writer or poet, is inherited from 
ancestors further back than can be remembered. The de- 
sire to commit crime is similar to the desire of a genius to 
develop the talents which are his. It is often the strongest 
passion of his life and for which he will give up every 
thing else, just as an artist will struggle along for years, 
going without the necessities that he might have in some 
other walk of life, that he may develop the talent which 
he feels within himself. 

"Born a criminal and forced by a power which cannot 
be understood to commit crime, I am no more responsible 
for what I am than are any of the geniuses of the age for 
what they are. The world honors these men and gives 
them credit for the work they do because it adds to the 
world's store of knowledge, but the men who do great things 
do not do them because they wish to add to the comfort 
and enjoyment of their fellowman, but because they can do 
nothing else. They have to do these things because they 
are made to do them. They do not deserve credit for what 
they accomplish, and a thief does not deserve censure for 
the harm he does to society. We can do nothing else. It 
is a part of him, of his very nature, to steal. 

"It is as impossible for me to lead an honest life as it 



Man's Moral Evolution. 



5 



is for some other men to become criminals. The criminal 
instinct, however, is more common than the instinct or de- 
sire to accomplish great things for the world's ^ood. All 
criminals are not alike and all are not affected by the same 
impelling force. Some are murderers and cut-throats, others 
are sneak thieves and porch climbers, and then there are 
men and women, too, who take the greatest satisfaction in 
robbing the less wary by their greater wit and cleverness. 
No class of mechanics take greater pride in their work than 
first-class cracksmen, who overcome the thousands of ob- 
stacles put in their way when they wish to open a vault. 
So marvelously skillful are many of these men that if they 
used the same energy and talent at honest employment 
they would be great inventors and would receive money 
and fame for what they accomplished, instead of being so- 
cial outcasts and always in danger of a policeman's bullet, 
or of a jail sentence. The risks they take in comparison 
to the rewards of their work are so great that, considered 
from a practical standpoint, the business does not pay. 

"Doubtless there are many robbers and thieves made 
so by necessity, but such men never become experts, and 
when the opportunity offers go back into legitimate lines of 
work if not captured by the police. Some among them 
have the criminal instinct in a degree, and when necessity 
compels them for the first time to commit a crime, it awak- 
ens the heretofore dormant instinct in them, and from that 
time on they are confirmed enemies of society." 

The questions connected with the case here cited, which 
criminologists are most deeply interested in are these: Did 
Dr. Patterson's constant association with criminals, his deep 
interest in their lives and the trend of their thoughts wear 
down his powers of resistance? Did the use of morphine 
during the later years of his life warp his mentality and 
blunt his perceptions? 

Were his criminal acts the result of rapidly approach- 
ing senility or, were they the result of congenital in- 
heritance as claimed by him? 

In an,>wer to a hypothetical question Dr. Frank Mc- 
Guire, one of the best known alienists and criminologists, 



6 



Albert S. Ashmead. 



said: "It is held by a number of celebrated alienists that 
the moral and intellectual spheres of thought are separate 
and distinct. 1 cannot think so. 1 do not believe that you 
can have the moral sphere seriously involved without in- 
volving to a certain degree the intellectual sphere. They 
may not be closely linked, but there is a certain connection 
between them. 

"The instinctive moral sentiment of a person will often 
rise above adverse environments. Children, when young, 
will show the moral sphere instinctively. Place many men 
in bad surroundings and they will still be moral. Take a 

man whose morals are blunted, for instance his intellect 

may be above the ordinary, but he may be a criminal from 
acquired habit. 

"The man referred to in this question, Dr. Patterson, 
is evidently a congenital criminal with a high grade of in- 
tellectuality, with which he covered up his crimes. This 
intellect led him to be careful. It placed him in a position 
which made his crimes safer and made him a much more 
dangerous man. He concealed his congenital moral defect 
under the garb of eminent respectability, because he had 
intellect enough to carry out the deception along that line. 

"That he was a forger was most natural. The more 
intellect a criminal posseses the higher the class of crime 
he will engage in. The only inconsistent thing about this 
case is the fact that the man committed burglary. This 
crime belongs naturally to a lower grade of intellect. It re- 
quires brute courage. Forgery or embezzlement, or high 
class sneak thievery would be more in line with his intellect. 

"Certainly morphine may have had something to do 
with it. Again it sometimes happens that there is evidence 
of moral defects in senility. 

"The man's instructive nature evidently exercised a 
considerably greater Influence upon his actions than did his 
intellectual nature. The defect of his moral sentiment might 
have been the result of defective organization, as he claims. 

"The instructive moral sentiment as a rule rises above 
defective environment although the moral attibutes of the 
mind are equally as transmissible as the physical. 



Man's Moral Evolution. 



7 



"Criminals, as a whole, may be divided into four 
classes as follows: 

First — Criminals whose moral sentiment is absent, or 
slightly developed and the intellect poor. These may be 
called born delinquents. 

Second — The insane delinquents whose moral sentiment 
is absent and the intellect so far developed as to be above 
the ordinary. Included in this class are congenital criminals 
and criminals from acquired habit. The criminal Patterson is 
probably of this class. 

Third — The moral sentiment is developed and guides 
the ordinary condition of the individual, but has feeble pow- 
ers of resistance. The mind is influenced by emotions. 
These are passional delinquents. 

Fourth — The moral is more or less developed, but be- 
comes perverted by a mental defect, epilepsy or alcoholism, 
the diseased brain giving new factors influencing the con- 
duct of the individual in his relation to society. 

"You may find all criminals under one or the other of 
these classifications, and I am pretty sure that the man we 
are speaking of comes under the second head. He resisted 
crime so long because his instructive sphere was stronger 
than his inherited tendencies. 

"Amputation of criminals' brains? Oh, no! Not until 
they begin to come into the world with a tag on each con- 
volution of the brain telling just what it is for." 

Dr. McGuire's closing remark on brain amputation is, 
to my understanding, an expression that Nature (or God) 
is oroDeriv presented bv the story of Eden, a heartless 
malefactor, whose evil worK Physicians and Pulpits have 
ever tried to undo. Vain labor! Individuals are comforted 
by them. But always a throng toward a Mecca. 

Faith is an utility, noi an evidence — a mixture nine 
parts Resignation, one part Hope. 

It is a matter of Temperament and not of Will. Many 
appear to have faith, who have it not — it is with such a 
business asset. 

Ingersoll has said: "No man has gone beyond the hor- 



8 



Albert S. Ashmead. 



izon of the Natural. I do not know whether the grave is 
a door or a wall." 

Youth is the only period when we bound over rough 
waters; as the age of 60 approaches, or is reached, a ma- 
lignity and persistence appears which is disastrous, though 
it may not be any more serious or portentous than the 
stumbling blocks of the earlier decades of life. All the day, 
like a cataractous one, we look through a fog. Yet we walk 
along freely using no more care than is required of the life 
pedestrian usually. But when the night time comes, we 
see more clearly, and do not feel that we have eyes. We 
are indifferent. Faith perhaps we have not. Resignation 
we possess, certain of a fixed and active principle of Evil to 
Nature, 10 which each being is to some degree and from 
time to time, a victim; the world has no more interest for 
us — it is the daily Eden and the creeping Serpent, with the 
Master looking on. 

Aided by the cool foggy air of late life, and the gray 
dawn of the approaching day, we may read the most interest- 
ing revelations like that of immorality in Japanese life, (which 
1 published in the Journal of Dermatology, July, 1906.) 

Only the more hopeless does it cause to appear the 
plan of the Natual Law. 

The two human civilizations, Occidental and Oriental, 
are now inpinging each upon the other — in obedience to 
the great principle of dissemination, the indiscriminate dis- 
semination everywhere seen. 

The plan of the union of the White races against the 
Yellow as suggested by the paper of Mr. Stein, of our de- 
partment of Commerce and Labor (Pan-Arya) would cer- 
tainly introduce among Occidentals the most dreaded feat- 
ure of Oriental life. The military success of Japan in the 
late war will be used to show that there is no God, or no 
Christian God, and that immorality has not weakened a 
people — no thought being bestowed upon the fact of Negro 
and Malay parent stock, the great animal base of the pres- 
ent human pyramid being there seen. 

In striking (and strange) contrast to the evil side of 
Oriental character I quote here a lyric and an extract from 



Man's Moral Evolution. 



9 



Lafcadio Hearn's latest work. They are so beautiful (no 
matter what their source) that 1 have selected them for the 
comparison : — 

JAPANESE LYRIC. 

My little bird, 

My bird born in my mother's tears, 
She flies, stretching her wings so, 

And from under her wings she drops my mother's message: — 
"Come home, Beloved!" 

Running out from my mother's bosom my little river, 
She suddenly stopped her song 
And looking up to the sun, 

She in her ripples flashed my mother's message: — 
"Come home, Beloved!" 
My roses, 

My little roses grow in my mother's breath; 
They are sad today, 
Casting their faces down, 

In their petals I read my mother's message: — 
"Come home, Beloved!" 

(Youe Noguchi, in National Magazine.) 

In his book "Kotoro," in the chapter entitled "After 
the War," Lafcadio Hearn, who was present at the return 
of the victorious troops at the close of the war (the Chinese- 
Japanese War) said to his old servant Manvenon: 

"Today you will be in Osaka and Nagoya. You will 
hear the bugle call and with its appeal you will think of 
your poor comrades who shall never again see home." 

The old man replied with quiet earnestness: 

"The people of the West believe, perhaps, that the dead 
never return. But we think otherwise: the Japanese dead 
all return, they know the way. From China and from 
Choisu they will come, and those who rest on the bottom 
of the sea, they all turn back — all. And when the darkness 
comes they will assemble together and impatiently await 
the signal call." 

in our last analysis of the Visible we see it is the 
Beauty and the Beast that has passed before us on the Kialto 
of life. That which the Great Playwright hath wrought 
the actors must do — their parts in life are not of their seek- 



10 



Albert S. Ashmead. 



ing and they cannot escape that from which they would 
later flee. 

Mr. Layton Crippen, a recent reviewer of Mr. Hight's 
book "The Unity of the Will,"* makes himself more con- 
spicuous than the book, that he leads the reader to expect 
would be presented. If I correctly apprehend the so-called 
review, the reviewer hides his incompetency under a garb 
of flippancy. Mr. Crippen is the author of "Olympus, and 
Fuji-Yami" (the Japanese Holy Mountain). He calls his 
review of Mr. Hight's work "The Mystery of the Human 
Will." 

Mr. Hight takes it for granted that the Will is the pri- 
mary reality; that the intellect is its instrument, and he 
gives credit to Schopenhauer for being the first philosopher 
to make this plain. Surely one can object to this conten- 
tion. Schopenhauer's philosophy was that of Buddha, it 
was that of Paracelsus, it was that of Jacob Boehme, it 
was that of the Oriental and Occidental mystics for thou- 
sands of years. "For God is but a great will pervading 
all things by nature of its intentness" — it is not necessary 
to say whence that quotation is taken. 

The sense of the Will inspired the greatest poets of 
the world; they, like Mr. Hight, feel that "all creation is 
permeated through and through and animated by an all- 
ruling Will, which is eternally striving to actualize itself in 
phenomenal life." This is Mr. Hight's central thought, and 
his argument is carried forward with a directness, a logic, 
a careful avoidance of unnecessary technicalities that are 
admirable. When it is said that on reading the work one 
fails to find a page that is superfluous it will be evident that 
even to give a bare outline of the thought in a brief review 
would be impossible. Here are one or two sentences from the 
chapter that takes its title from the title of the book, which 
will give some help to a realization of the idea: 

"A miraculous force is seen welling up from the depths 
of nature, shaping, adjusting, creating; whether we call it 
"vital force" or "psychical law" matters very little; that 



•The Unity of the Will. Studies of an Irrational ist. By George Aiuslie 
Hight. New York: E. P. Dutton & Co. 53. 



Man's Moral Evolution. 



11 



depends upon our own individual standpoint, but the im- 
portant thing is that it is one, and is tending to one end 
through all the varied means, through adaptation, strife, 
failure, better adjustment, and final survival of the fittest; 
often failing and again beginning with renewed effort till 
the end is gained. No one can see the will; but what if 
does we see, and if it cease the action also will cease. 
Our consciousness, the onlooker, shows it as a judge, 01 
referee, allowing or disallowing, but taking no part in the 
action, only using physical causality as the instrument of 
its projection into objectivity. Every action is possible to 
the will; it is all-creative; as every pattern is possible to 
the lacemaker sitting with her bobbins before her, and weav- 
ing, by simple movement of one thread and another, just 
that web which she desires; as all literature is open to the 
typewriter, who produces the sentences he wishes for by 
touching the levers in turn, never breaking the causal se- 
quence, but simply pressing or abstaining. Thus do the 
varied causal actions of the Universe lie readv before the 
will to allow or disallow as it pleases; the levers are in do 
sition, and as it presses with the mechanism of a human 
brain now one and then another of them, as it reacts me- 
chanically to an impression, or lays it by for trie future, 
furnishes or withholds a supply to meet a demand, so it 
brings forth the harmony of active life. For that harmony 
which enables each thing to fulfill its functions among oth- 
ers around it, which makes it appear as if designed to ful- 
fill a purpose, that, and not the material composition of its 
substance, is its true being." 

Such, briefly and quite inadequately suggested in this 
review, is the main idea of Mr. Hight's book. But there 
is another purpose in the work — a purpose to which the 
development of this. main idea is perhaps only incidental in 
the author's mind. "The Unity of Will" is a bitter, pow- 
erful attack on modern science. In grave words, Mr. Hight 
warns civilization of the peril, which in his opinion, threat- 
ens it: 

"Science now assumes the control of civilization, as once 
did theology, and its career will be the same. Will anv 



12 



Albert S. Ashmead. 



one deny that rationalist science commits the sophistry of 
seeking to prove and disprove by words alone things for 
which no data exist, that it assumes artificial concepts of 
things unknown, or that logical theory in upholding the su- 
premacy of reason abets it therein? A glance at any aca- 
demical journal will show what our universities understand 
by knowledge. Questions are discussed which never can 
be answered; views expanded which never can be tested, 
because they deal with things long passed away and un- 
verifiable; "authority" means the opinion of one who has 
read most of the opinions of others, and this is called eru- 
dition. * * * 

"It will doubtless be urged that there is nothing in mod- 
ern science to contradict the existence of an unseen world; 
the evidence for it has often been dwelt upon by scientific 
writers themselves. Only the two worlds are separate; 
science merely regards the one as lying beyond her sphere, 
because to confuse the two would hinder her own special 
work. "What can be more innocent than agnosticism?" 
says the follower of science: "I do not choose to say that 
I know what I do not know." It is not the modest con- 
fession of ignorance that one wishes to find fault with, but 
the aggressive, intolerant attitude which science adopts to- 
wards those who go elsewhere than to her for inspiration; 
who choose other methods than those which she prescribes; 
her aggressive controversies, made to rest upon words for 
things which do not exist, such as the word miracle. If to 
think that what is wonderful must be the work of God be 
a thing so dreadful that the whole artillery of science must 
be brought to destroy it, then Heaven help us, for we all 
think it!" 

I do not understand that the author considers the "Mys- 
tery of the Human Will," but, rather the question, whether 
there is to be seen evidence of the Supreme Will of an In- 
telligent Designer; who has ordained and instituted a Plan 
and left the details of the operation, indifferent towards the 
fates of individuals — in which case there exists no mystery 
of the human will — for human will does not exist. 



Man's Moral Evolution. 



13 



My view of the Plan is quite definite, and, I believe, 
consistent in all its parts. 

It has come to be admitted that Nature is Energy. 
But energy and force are confusedly used. Let me present 
the following: Force is localized Energy. Under that form- 
ula, Unity is seen. The diffused heat and light of the sun 
is localized as to results of animate and still life on earth 
according to soil, latitude, altitude. It is the Plan with 
which we come in contact; the Plan that we can in a small 
degree, as to its relation to our daily fortunes, get a glimpse 
of. But its Creator we are not permitted to approach. 
Before the Great Unknown we can only grovel and cry: O, 
God where art thou! Why go so far afield? We are not 
wanted there until the ultimate is reached. Looking and 
longing we are no more advanced in the knowledge of God 
than isthe dullest or the wickedest savage. All that is refined 
and pleasant in this communal life of men has been wrested 
from the brutality of nature in the efforts of man to con- 
struct ethics and codes for the protection of himself and his 
posterity. Let man apply himself to zcork, and pass theory. 

To some extent (perhaps wholly) I continue the thoughts 
dimly expressed, evoked by the ' 'review' 1 or notice of Dr. 
Hight's book "Unity of the Will." 

It is the "work" of the world in which each human 
atom is individually engaged without the slightest will of 
his or her own. It is the evidence of involuntary "Natural 
Selection." To me (if 1 may not be deemed as making 
myself too prominent) has come the joy of unmasking (from 
my experience) the duplicity of the Divine Order of things. 
To me it is in addition to the humanity of my profession, 
its solaces, etc., the war upon Japanese monstrosity, and 
the enlightenment for the social system, as to what is com- 
ing against them, and as to which, the West, in its Chris- 
tian altruism and egotism it is surely coming: in contact. 
Professor Cook's Evolution (Kinetic) in man (see Relation 
of Man to Nature [Medical Fortnightly] by myself) involves 
kinetic Evolution: and the agents on each side are as in- 
voluntary as are the seeds of food, or of famine that are 
wafted over the face of the earth by the airs of Heaven. 



14 



Albert S. Ashmead. 



If sentience to some degree exists in everything (as some 
horticulturists have come to assert, and as Haeckel in his 
"Insulinde" as to particular vegetable growth suggests ex- 
perimentally), can the green and later rich and glowing 
grain have altruistic satisfaction at the contemplation of the 
process that it must undergo in its mission towards the 
amelioration of the life of contemporaries, all looking under 
the belief (and truth) of a Divine Plan for a glorious 
outcome for all millions of years hence? It is against this 
egregious Fallacy that I protest — a Fallacy because in no 
relation except that of the Unknown is it tolerated. 

It may be (and is) said that the universality of such 
a belief or trust or hope (with its varied and often grotesque 
expressions) is an indication of the probable benign purpose. 
But, what is benignity in futuro? Bah! It is but a 
word with which to conjure. It is the juggler's trick. Sup- 
pose we assume confidently that it is of serious import* 
leading towards and finally to, a substantiality. Shall I, 
for instance, be content; shall I, for instance, roll my vi- 
carious blood as a sweet morsel under my tongue, and die 
with the contorted face of agony, content to have it inter- 
preted by the favored onlookers as the smile of rapture? 
No! Ever No! That which is not just between man and 
man, is not just between God and man. I stand for a 
"square deal" and for it I will stand ever while on earth, 
as between God and myself, I fear not. 

Under what is called The Divine Plan, what is Life 
except a play of Harpies? What is the preaching of the 
pulpit except a gloze, or a shiny glaze, upon the surface of 
a treacherous interior, of God ordained? 

What does that gloze, or glaze, except to conceal the 
devilishness of the system? What system? The System 
Divine. What mortal can successfully contend against it? 
Not one. Shall it be further insisted that Christ (of the 
Occidentals) was the Son of God, sent to redeem the world 
and bring it back to God, when surely as the sun will con- 
tinue to rise day after day, Orientalism in its hideous feat- 
ures will come out and make hold upon and pervert that 
from which it has been hoped the world was free — 



Man's Moral Evolution. 



15 



the New World? Indeed, that which was known only sub- 
rosa (of Japanese, for instance). 

Yet only by such laying bare can the world be fore- 
warned. The discouraging feature is that while the "Di- 
vine Plan" will thus (hopedly) exterminate the Evil by 
showing the Japanese the quality of their fancies, thousands 
upon thousands of the anti -pathetics will themselves become 
victims. 

This is the devilishness of the Natural Law, the law of 
God. It is the devilishness of our Occidental God Himself 
if God there be. 

These be temperate and sober words, and by them I 
will stand. 1 feel an earnestness I cannot suppress. 

Omar Khay-Yham asks God "to man's forgiveness 
give — and take. 11 

God, I make bold to say, is to be pardoned; it is not 
for Him to pardon man. 

And such is the lesson of the Story of Eden. The Kaiser 
of Germany was right in warning the people of Europe to 
preserve their "highest treasures". ("Volken Europas, 
wahret eure hochsten Giiten." Wilhelm II). 

But what does it mean except bloody war or heart- 
rending silence? Doctors and Reverends, out with the 
sickly sentimental idea of God and Heaven! Let us teach 
what God is as developed by His contact with the face of 
the earth; let us no longer conceal His "true inwardness." 
Let us take the Proverbs of Soloman, and hang them upon 
the walls of our dwellings, of our schools, of our lecture 
rooms. Let us be a serious people. Let us do away with 
sickly namby-pamby pulpit-pratings, or pulpit-platitudes and 
pretences. Let us have common sense. When the son takes up 
the catechism and reads a page of questions and answers, and 
looks at his father and says: "Do you believe that?" and 
the father makes no reply; and the boy says: "If you do 
not believe it, how can I?" and shuts the book and leaves 
the room never to open that book again, what has been 
the result of that Church nonsense except to put the child 
wholly at the mercy of the world as it is, which is not the 
world that the goody-goody gush has poured into his ears. 



16 



Albert S. Ashmead. 



We know that "The System" is such a tangled web 
that in the warp and the woof, good and evil are inextri- 
cably mixed. Let us say so. The responsibility is with God 
Almighty. Man is to be blamed for nothing. As I have fre- 
quently pointed out, pagan and immoral Japan has become 
the bete-noire of the modern civilized world. Herein is to 
be found again, as always, the aggravation inflicted upon 
mankind. 

But all this lament, and energy of thought is but waste. 
All is naught, joy and jest: travail and tears: the old, old 
story. 

All crime is the crime of Nature against man and man- 
kind. But man, the individual, takes upon himself the 
blameworthiness for the result. 

Let us be reasonable; let us be as logical as our reason- 
ing powers shall permit. 

If we are not responsible for the activity of our brain 
and tissue cells (as believers in heredity of crime tell us), 
then are we indeed involuntaries, and are immediately 
brought to stand with Calvin, who preached that a certain 
number of infants are born to be damned. He meant a per 
cent, of course. What difference between him and Karma 
(the Sanscrit merit and demerit of intelligent existence) as 
I understand the teaching of Karma? Each presents a con- 
tinuing Good and a continuing Evil. But in the operation 
of The Plan the good is not immune ag-ainst evil, and the 
work of demolition goes ever on. Here and there Good 
modifies Evil, and Evil deterioriates Good, where it does 
not destroy the Good that it attacks. But Good perseveres 
in reproducing Good, and Evil perpetuates itself. If they 
are relative terms then indeed is man unfortunate in all his 
speculations as to a Divine Immaculate, for the Immaculate 
is not deemed to be in charge of man's welfare on earth. 
Then our God is not Purity, Goodness and Truth. 

Indeed, what fair argumentative ground have we for 
supposing that we have such a Divine Governor? Man is 
a product of evolution. His statutory and social laws he 
has made to protoct himself against the great principles ac- 
knowledged by Calvin and Karma — the Occidental and the 



Man's Moral Evolution. 



17 



Oriental. The one is aggressive; the other passive. Ex- 
tremes meet. Calvin would use fire and sword; Karma 
would sigh and fold the hands with conviction of utter 
helplessness. And the one would be as effective as the 
other. 

The Creator is alone responsible for every feature of life. 

Two refuges are presented: (1) Faith and the aban- 
donment of Reason; (2) Reason and the abandonment of 
Faith. 

The Rationalist has chosen the latter, and is content. 
Again extremes meet. When direct opposites come at last 
to the same point — being the intended and desired destina- 
tion, then where shall man look for a guide? For a guide 
to calm? 

The Pulpit (a Religion) is best for the many. Relig- 
ion is an emotion. The members of the congregation en- 
courage each other by the Sunday assembly. The Church 
must remain. We need it, as a community; as a nation 
we need it. . . Rationalism is for the individual. Each 
is an utility. We must select that which is to each the 
most useful. 

I look upon my underlined declaration in a previous 
paragraph: "All Crime is Crime of Nature against Man and 
Mankind," as final definitive of all my views (if my views 
are worthy of consideration) ; and I give it as a challenge 
to the world. I look upon it as a Crux, from which is de- 
pendent on all sides the spectacle that man is COMPELLED 
to behold. 1 have no apology to make for the definition; 
look upon it only as a form logical that has never before 
been thus plainly put. 

I do not in the slightest sense suggest that any one 
reply either with or against. 

It is my fight; and I believe 1 shall never be beaten. 
I am not a '"crank." 1 recognize utilities; and I know so- 
ciety needs utilities. 

It is "utility" that makes society useful to individuals, 
without any dwelling upon the finally utile. 

This is not a "kick." It is a period. 

(To be continued.) 



EROTIC SYMBOLISM.* 



BY HAVELOCK ELLIS, M. D., 

Carbos Water, Lelant, Cornwall, England. 

There is ample evidence to show that, either as a 
habitual or more usually an occasional act, the impulse tol 
bestow a symbolic value on the act of urination in a be-, 
loved person, is not extremely uncommon; it has been 
noted by men of high intellectual distinction; it occurs in 
women as well as men; it must be regarded as within the 
normal limits of variation of sexual emotion. 

The occasional cases in which the urine is drunk may 
possibly suggest that the motive lies in the properties of 
the fluid acting on the system. Support for this supposi- 
tion might be found in the fact that urine actually does 
possess, apart altogether from its magic virtue embodied in 
folk-lore, the properties of a general stimulant. In compo- 
sition (as Masterman first pointed out) "beef tea differs 
very little from healthy urine," containing exactly the same 
constituents, except that in beef tea there is less urea and 
uric acid. Fresh urine — more especially that of children and 
young women — is taken as a medicine in nearly all parts 
of the world for various disorders, such as epistaxis, malaria 
and hysteria, with benefit, this benefit being almost certain- 
ly due to its qualities as a general stimulant and restora- 
tive. William Salmon's Dispensatory, 1678, shows that in 
the seventeenth century urine still occupied an important 
place as a medicine, and it entered largely into the compo- 
sition of Aqua Divina. 

Its use has been known even in England in the nine- 



♦Continued from November, 1906. 

18 



Erotic Symbolism. 



19 



teenth century.* Bourke brings together a great deal of 
evidence as to the therapeutic uses of urine in his Scatalogic 
Rites; Lusinif has shown that normal urine invariably in- 
creases the frequency of the heart beats. 

But it is an error to suppose that these facts account 
for the urolagnic drinking of urine. As in the gratification 
of a normal sexual impulse, the intense excitement of grat- 
ifying a scatalogic sexual impulse itself produces a degree 
of emotional stimulation far greater than the ingestion of a 
small amount of animal extractives would be adequate to 
effect. In such cases, as much as in normal sexuality, the 
stimulation is clearly psychic. 

When, as is most commonly the case, it is the process 
of urination and not the urine itself which is attractive, 
there occurs a symbolism of act and not the fetichistic at- 
traction of an excretion. When the excretion apart from 
the act provides the attraction, we seem usually to be con- 
cerned with an olfactory fetichism. These fetichisms in the 
case of the excretia, seem to be experienced chiefly by in- 
dividuals who are somewhat weak-minded, which is not 
necessarily the case in regard to those persons for whom 
the act, rather than its product apart from the beloved 
person, is the attractive symbol. 

The sexually symbolic nature of the act of urination 
for many people is indicated by the fact that Bloch, in 
enumerating various kinds of indecent photographs, refers 
to a group which he terms "the notorious pisseuses." It is 
further indicated by several of the reproductions in Fuch's 
Erotische Element in der Karikatur, such as Delorme's "La 
Necessite n' a point de Loi." (It should be added that 
such a scene by no means necessarily possesses any erotic 
symbolism, as we may see in Rembrandt's etching com- 
monly called "La Femme qui Pisse" in which the reflected 
lights on the partly shadowed stream furnish an artistic 
motive which is obviously free from any trace of obscenity.) 
The case in which Krafft-Ebing quotes from Maschka of a 

♦Masterman, Lancet, 2 Oct. 1880; R. Neale, Urine as a Medicine," Practitioner, 
Nov. 1881. 

\Archivio di Farmacologia, fasos 19-21, 1893. 



20 



Havelock Ellis. 



young man who would induce young girls to dance nake ! 
in his room, to leap, and to urinate in his presence! 
whereupon seminal ejaculation would take place in himsell 1 
is a typical example of urolagnic symbolism in a form ade ; 
quate to produce complete gratification. 

A case in which the urolagnic form of scatalogic sym 
bolism reached its fullest sexual development as a sexui 
perversion has been described in Russia by Sukhanoff.* J 
young man of 27, of neuropathic temperament, who whe • 
he once chanced to witness a woman urinating, experience ' 1 
voluptuous sensations. From that moment he sought closl; 
contact with women urinating, the maximum of gratification be I 
ing reached when he could place himself in such a positioi! 
that a woman, in all innocence, would urinate into hi! 
mouth. All his amorous adventures were concerned witj 
the search for opportunities for procuring this difficult grati 
fication. Closets, in which he was able to hide winte; 
weather and dull days, he found most favorable to success. I 

In a case communicated to me, a young man of aristo 
cratic family, was accustomed to watch the movements (| 
lady guests and, after they had visited their bed -rooms I 
immediately seek and remove to his own room vessels con|» 
taining freshly voided urine. One day he was met by jj 
lady who unexpectedly returned to the room she had juf|| 
left. He was placed under medical observation, but wa 
undoubtedly sane. 

In the apparently similar case of a robust man ( 
neuropathic heredity recorded by Pelanda, there was mas 
turbation up to the age of 16, when he abandoned th 
practice and, up to the age of 30, found complete satis 
faction in drinking the still hot urine of women. When 
lady or girl in the house went to her room to satisfy 
need of this kind, she had hardly left it but he hastene 
in, overcome by extreme excitement, culminating in spon 
taneous ejaculation. The younger the woman the greate 
the transport he experienced. It is noteworthy that i 

*Archives d' Anthropologic Criminclle, Nov. 19, and Annalles Medico-psychologiqm i 
February, 1901. 

tA somewhat similar case is recorded in the Archives dc Neurologic, 1902, p. 4( 



Erotic Symbolism. 



21 



is, as possibly in all similar cases, there was no sensory 
aversion and no morbid attraction of taste or smell; he 
ated that the action of his senses was suspended by his 
incitement, and that he was quite unable to perceive the 
lor or taste of the fluid.* It is in the emotional symbol - 
m that the fascination lies, and not in the sensory per- 
ersion. 

Magnant records the spontaneous development of this 
; ?xual symbolism in a girl of eleven, of good intellectual 
evelopment but alcoholic heredity, who seduced a boy 
:ounger than herself to mutual masturbation, and on one 
,ccasion lying on the ground and raising her clothes asked 
jim to urinate on her. This case (except for the early 
jge of the subject) is a fairly typical example of a sporadi- 
ally occurring urolagnic symbolism in a woman, to whom 
uch symbolism is fairly obvious on account of the close 
esemblance between the emission of urine and the ejacu- 
ation of semen in the man, and the fact that the same 
onduit serves for both fluids. J A urolagnic day-dream of 
his kind is recorded in the history of a lady contained in 
appendix B. History. The natural inevitable character of 
his symbolism is shown by the fact that among primitive 
)eoples urine is sometimes supposed to possess the fertilizing 
/irtues of semen. J. G. Frazer§ brings together various 
stories of women impregnated by urine. Hartlandll also 
ecords legends of women impregnated by accidentally or 
ntentionally drinking urine. 

The symbolic sexual significance of urolagnia has hith- 
?rto usually been confused with the fetichistic and mainly 
)lfactory perversion by which the excretion itself becomes 
a source of sexual excitement. Long since Tardieu referred, 
under the name of "renifleurs," to persons who were said 
to haunt the neighborhood of quiet passages, more especially 
in the neighborhood of theatres, and who when they per- 

*"Pornopatici," Archivio di Psichiatria, fasc. 111-iv., 1889, p. 356. 
tlnternational Congress of Criminal Anthropology, 1889. 

{Psychology of Sex, Vol. III. 

§Pausanias, Vol. IV, p. 139. 

WLegend.of Perseus, Vol. I, pp. 76, 92. 



22 



Havelock Ellis. 



ceived a woman emerge after urination, would hasten to 
excite themselves by the odor of the excretion. Possibly 
a fetichism of this kind existed in a case recorded by 
Belletrud and Mercier; a weak-minded, timid youth who 
was very sexual but not attractive to women, would watch 
for women who were about to urinate and immediately 
they had passed would go and lick the spot they had 
moistened, at the same time masturbating. Such a fetichistic 
perversion is strictly analogous to the fetichism by which 
woman's handkerchiefs, aprons or underlinen became capable 
of affording sexual gratification. A very complete case of 
such urolagnic fetichism — complete because separated from 
association with the person accomplishing the act of urina- 
tion — has been recorded by Moraglia in a woman. It is the 
case of a beautiful and attractive young woman of eighteen, 
with thick black hair, and expressive, vivacious eyes, but 
sallow complexion. Married a year previously but childless, 
she experienced a certain amount of pleasure in coitus but" 
she preferred masturbation, and frankly acknowledged that 
she was highly excited by the odor of fermented urine. 
So strong was this fetichism that when, for instance, she 
passed a street urinal she was often obliged to go aside 
and masturbate; once she went for this purpose into the 
urinal itself and was almost discovered in the act, and on 
another occasion into a church. Her perversion caused her 
much worry because of the fear of detection. She preferred, 
when she could, to obtain a bottle of urine — which must 
be old and a man's (this, she said, she could detect by 
the smell) — and to shut herself up in her own room, holding 
the bottle in one hand and repeatedly masturbating with 
the other. t This case is of especial interest because of the 
great rarity of fully developed fetichism in women. In a 
slight and germinal degree I believe that cases of fetichism 
are not uncommon in women, but they are certainly rare 
in a well-marked form, and Krafft-Ebing declared, even in 
the late editions of his Psvchopathia Sexualis, that he knew 
of no cases in women. 

♦Annales d'Hygiene Publique, June 1904, p. 48. 
tArchivio di Psichiatria, (Vol. XIII, fasc. 6. p. 267, 1892.) 



Erotic Symbolism. 



23 



So far we have been concerned with the urolagnic 
rather than the coprolagnic variety of scatalogical symbolism. 
Although the two are sometimes associated there is no 
necessary connection and most usually there is no tendency 
for the one to involve the other. Urolagnia is certainly 
much the more frequently found; the act of urination is 
ifar more apt to suggest erotically symbolical ideas than the 
idea of defecation. It is not difficult to understand why 
this should be so. The act of urination lends itself more 
easily to sexual symbolism; it is more intimately associated 
with the genital function; its repetition is necessary at 
more frequent intervals so that it is more in evidence; 
moreover its product is much less offensive to the senses 
than that of the act of defecation, and the act of urination 
has sometimes furnished a motive to the painter. Still 
coprolagnia occurs and not so very infrequently, Burton 
remarked, that even the normal lover is affected by this 
feeling: "immo nec ipsum amicae stercus foetet."* Of 
Caligula who, however was scarcely sane, it was said 
< mt et quidem stercus uxoris degustavit." In Parisian brothels 
(according to Taxil and others) provision is made for those 
who are sexually excited by the spectacle of the act of 
:defecationt (without reference to contact or odor) by means 
of a "tabouret de verre f ,f from under the glass floor, from 
where the spectacle of the defecating women may 
be closely observed. It may be added that the pleasure 
of such a spectacle is referred to in the Marquis de Sade's 
novels. The stercoraires are described by Borouordel as 
watchers of women's urinals. 

There is one motive for the existence of coprolagnia 
which must not be passed over because it has doubtless 
frequently served as a mode of transition to what, taken 
by itself, may well seem the least aesthetically attractive 
of erotic symbols. I refer to the tendency of the nates to 
become a sexual fetich. The nates have in all ages and 
in all parts of the world been frequently regarded as one 



* Anatomy of Melancholy, Part 111, Sect, 11, Mem. Ill, Subs. 1. 
tGazette des Hopitano, 1888. 



24 



Havelock Ellis. 



of the most aesthetically beautiful parts of the feminine 
body.* It is probable that on the basis of this entirely 
normal attraction more than one form of erotic symbolism 
is at all events in part supported. Diihren and others have 
considered that the aesthetic charm of the nates is 
one of the motives which prompt the desire to inflict flag- 
ellation on women. In the same way — certainly in some 
and probably in many cases — the sexual charm of the 
nates progressively extends to the anal region, to the act of 
defecation, and finally to the excreta. 

It may be remarked that while the eating of excrement 
(apart from its former use and as a magic charm and as a ther- 
apeutic agent) is in civilization now confined to sexual perverts 
and the insane, among some animals it is normal as a 
measure of hygiene in relation to their young. Thus, as, 
e. g. the Rev. Arthur East writes, the mistle thrush swal- 
lows the droppings of its young. t In the dog I have 
observed that the bitch licks her puppies shortly after birth 
as they urinate, absorbing the fluid. 

In a case of Krafft-Ebing's the subject, when a child 
of six, accidentally placed his hand in contact with the nates 
of the little girl who sat next to him in school and experi- 
enced so great a pleasure in this contact that he frequently 
repeated it; when he was ten a nursery governess to gratify 
her own desire placed his finger in her vagina; in adult 
life he developed urolagnic tendencies. 

In a case of Moll's the development of a youthful 
admiration for the nates in a coprolagnic direction may be 
still more clearly traced. In this case a young man, a 
merchant in a good position, sought to come in contact 
with women defecating; and with this object would seek 
to conceal himself in closets; the excretal odor was pleas- 
urable to him but was not essential to gratification, and 
the sight of the nates was also exciting and at the same 
time not essential to gratification; the act of defecation 
appears, however, to have been regarded as essential. He 

*See, e.g. the previous volume of these Studies, "Sexual Selection in Man," 
pp. 185 et seq., and Duhren, Geschlechtsleben in England,, Bd. 11, pp. 258 et seq. 
fKnowledge, June 1, 1892. 



Erotic Symbolism. 



25 



never sought to witness prostitutes in this situation; he 
was only attracted to young, pretty and innocent women. 
The coprolagnia here, however, had its source in a childish 
impression of admiration for the nates. When five or six 
years old he crawled under the clothes of a servant girl, his 
face coming in contact with her nates, an impression that 
remained associated in his mind with pleasure. Three or 
four years later he used to experience much pleasure when 
a young girl cousin sat on his face; thus was strengthened 
an association which developed naturally into coprolagnia.* 

It is scarcely necessary to remark that an admiration 
for the nates, even when reaching a fetichistic degree, by 
no means necessarily involves, even after many years, any 
attraction to the excreta. A correspondent for whom the 
nates have constituted a fetich for many years writes: "I 
find my craving for women with profuse pelvic or posterior 
development is growing and I wish to copulate from behind; 
but I would feel a sickening feeling if any part of my 
person came in contact with the female anus. It is more 
pleasing to me to see the nates than the mons, yet I loathe 
everything associated with the anal region." 

Moll has recorded in detail a case of what may be 
described as "ideal coprolagnia — that is to say, where the 
symbolism, though fully developed in imagination, was not 
carried into real life— which is of great interest because it 
shows how in a highly intelligent subject the deviated sym- 
bolism may become highly developed and irradiate all the 
views of life in the same way as the normal impulse. 
(The subject's desires were also inverted but from the 
present point of view the psychological interest of the case 
is not thereby impaired.) Moll's case was one of symbolism 
of act, the excreta offering no attraction apart from the 
pro;ess of defecation. In a case which has been commu- 
nicated to me there was, on the other hand, an olfactory 
fetichistic attraction to the excreta even in the absence of 
the person. 

In Moll's case, the patient X, twenty-three years of 



*Untersuchungen uber die Libido Sexualis, Bd. 1, p. 887. 



26 



Have lock Ellis. 



age, belongs to a family which he himself describes as 
nervous. His mother, who is anaemic, has long suffered 
from almost periodical attacks of excitement, weakness, 
syncope and palpitation. A brother of the mother died in 
a lunatic asylum and several other brothers complain much 
of their nerves. The mother's sisters are very good-natured 
but liable to break out in furious passions; this they in- 
herit from their father. There appears to be no nervous 
disease on the patient's father's side. X's sisters are also 
healthy. 

X. himself is of powerful, undersized build and enjoys 
good health, injured by no excesses. He considers himself 
nervous. He worked hard at school and was always the 
first in his class; he adds, however, that this is due less to 
his own abilities than the laziness of his school-fellows. 
He is, as he remarks, very religious and prays frequently, 
but seldom goes to church. 

During his school -days he had periodic fits of depres- 
sion and misanthropic depression. He refers also to his 
extreme pedantry at this period. These fits are now much 
less marked. In society he is not communicative. 

In regard to his psychic character he says that he 
has no specially prominent talent, but is much inter- 
ested in languages, mathematics, physics and philoso- 
phy, in fact in abstract subjects generally. "While 1 take 
a lively interest in every kind of intellectual work," he 
says, "it is only recently that 1 have been attracted to real 
life and its requirements. I have never had much skill in 
physical exercises. For external things, until recently, I 
have only had contempt. I have a delicately constituted 
nature, loving solitude, and only associating with a few se- 
lect persons. I have a decided taste for fiction, poetry and 
music; my temperament is idealistic and religious, with 
strict conceptions of duty and morality and aspirations to- 
wards the good and beautiful. I detest all that is common 
and coarse, and yet 1 can think and act in the way you 
will learn from the following pages." 

Regarding his sexual life X has made the following 



Erotic Symbolism. 



27 



communication: "During the last two years I have become 
convinced of perversion of my sexual instinct. 1 had often 
previously thought that in me the impulse was not quite 
normal, but it is only lately that I have become convinced of 
my complete perversion. I have never read or heard of 
any case in which the sexual feelings were of the same 
kind. Although I can feel a lively inclination towards su- 
perior representatives of the female sex, and have twice felt 
something like love, the sight or the recollection even of a 
beautiful woman have never caused sexual excitement." In 
the two exceptional instances mentioned, it appears that X. 
had an inclination to kiss the women in question, but that 
the thought of coitus had no attraction. "In my voluptuous 
dreams, connected with the emission of semen, women in 
seductive situations have never appeared. have never 
had any desire to visit a harlot. The love stories of my 
fellow- students seemed very silly, dances and balls were a 
horror to me, and only on very rare occasions could I be 
persuaded to go into society. It will be easy to guess the 
diagnosis in my case: I suffer from the sexual attraction of 
my own sex, I am a lover of boys. 

"You cannot imagine what a world of thoughts, wishes, 
feelings and impulses the words 'Knabe,' 'garcon,' 'boy/ 
'ragazzo' have for me; one of these words, even in an un- 
meaning clause of the translation-book, calls before me the 
whole sum of associations, which in course of time have be- 
come bound up with this idea, and it is only with an ef- 
fort that I can scare away the wild band. This group of 
thoughts shows a wonderful mixture of warm sensuality and 
ideal love; it unites my lowest and highest impulses, the 
strength and weakness of my nature, my curse and my 
blessing. My inclination is especially towards boys of the 
age of 12 to 15; though they may be rather younger or 
older. That I should prefer beautifu and intelligent boys 
is comprehensible. I do not want a p r ostitute, but a friend 
or a son, whose soul I love; whom I can help to become a 
more perfect man, such as I myself would willingly be. 

"When 1, myself, belonged to that happy age (i. e. be- 



28 



Havelock Ellis. 



low 15) I had no dearer wish than to possess a friend of 
similar tastes. I have sought, hoped, waited, grieved, and 
been at last disillusioned, overcome by desire and despair, 
and have not found that friend. Even later the hope often 
reappeared, but always in vain, and I cannot boast of that 
sure recognition which one reads of in the autobiographies 
of Urnings. I do not know personally a single fellow- 
sufferer. It is also doubtful whether such an acquaintance- 
ship would greatly help me, for I have a very peculiar con- 
ception of homosexuality. As you will see, I have little 
more in common with what are called paederasts, than sex- 
ual indifference to the female sex, and I often ask myself: 
'Does any other man in the whole world feel like you? 
Are you alone in the earth with your morbid desires? Are 
you a pariah among pariahs, or is there perhaps another 
soul with similar longings living near you?' How often in 
summer have I gone to the lakes and streams outside cit- 
ies to seek boys bathing; but I always came back unsatis- 
fied, whether 1 found any or not. And in winter I have 
been irresistibly impelled to return to the same spots as if 
it were sanctified by the boys, but my darlings had van- 
ished and cold winds blew over the icy floods, so that I 
would return feeling as though I had buried my happi- 
ness. 

"It must be borne in mind, therefore, that what I have 
to say regarding my sexual impulses only refers to fancies 
and never to their practical realization. My sensual im- 
pulses are not connected with the sexual organs; all my 
voluptuous ideas are not in the least connected with these 
parts. For this reason I have never practiced onanism and 
immissio membri in anum is repulsive to me as to normal 
man. Even every imitation of coitus is, for me, without at- 
traction. In a boy's body two things especially excite me: 
his belly and his nates, the first as containing the digest- 
ive tract, the second as holding the opening of the bowels. 
Of the vegetable processes of life in the boy, none inter- 
est me nearly so much as the progress of his digestion and 
the process of defecation. It is incredible to what an ex- 



Erotic Symbolism. 



29 



tent this part of physiology has occupied me from youth. 
If, as a boy, I wanted to read something of a piquantly ex- 
citing character, I sought in my father's encyclopaedia for 
articles like: Obstruction, Constipation, Haemorrhoids, 
Faeces, etc. No function of the body seemed to be so sig- 
nificant as this, and I regarded its disturbances as the most 
important in the whole mechanism of life. The description 
of other disorders I could read in cold blood, but intussus- 
ception of the bowels makes me ill even to-day. I am al- 
ways extremely pleased to hear that the digestion of peo- 
ple around me is in good condition. A man who did not 
sufficiently watch over his digestion aroused distrust in me 
and I imagined that wicked men must be horribly indiffer- 
ent regarding this weighty matter. Even more than in or- 
dinary persons was I interested in the digestion of more 
mysterious beings, like magicians in legends, or men of 
other nations. I would willingly have made an anthropo- 
logical study of my favorite subject, only to my annoyance 
books nearly always pass over the matter in silence. In 
history and fiction I regretted the absence of information 
concerning the state of my heroes' digestion when they 
languished in prison, or in some unaccustomed or unhealthy 
spot. For this reason I held no book more precious than 
the one which describes how a young man, after being ship- 
wrecked, lived for a long time in a narrow snow-hut, and 
it was conscientiously stated that he became conscious of 
digestive disturbances. No immorality angers me more than 
the foolish practice of ladies who in society neglect the 
satisfaction of their natural needs from misplaced motives 
of modesty. On a railway journey I suffer horribly from 
the thought that one of my fellow-travellers may be pre- 
vented from fulfilling some imperative natural necessity. 

"I naturally devote the greatest attention to my own 
digestion. With painful conscientiousness 1 go to stool 
every day at the same hour; if the operation does not 
come off to my satisfaction, I feel not so much physical as 
mental discomfort. To this quite useful hygienic interest 
became associated at puberty a sensual interest. Since 



30 



Havelock Ellis. 



my fourteenth year I have had no greater enjoyment than 
to defecate undressed (I do not do so now) after having 
first carefully examined the distention of my abdomen. In 
summer I would go into the woods, undress myself in a 
secluded spot and indulge in the voluptuous pleasures of de- 
faecation. I would sometimes combine with this a bath in 
a stream, 1 would exhaust my imagination in the effort to 
invent specially enjoyable variations, longed for a desert 
island where I could go about naked, fill my body with 
much nourishing food, hold in the excrement as long as 
possible, and then discharge it in some subtly thought- 
out spot. These practices and ideas often caused erections 
and later on emissions, but the genitals played no part in 
my conceptions; their movements were uncomfortable and 
gave no pleasure. 

''1 soon longed to be associated in these orgies with 
some boy of the same age, but I wanted not only a com- 
panion in my passion but also a real friend. Since there 
could be no question of masturbation or paedicatis, our love 
would have been limited to kisses, embraces, and— as a 
compensation for coitus — defaecation together. That would 
have been perfect bliss to me. 1 will spare you the un- 
aesthetic contents of my voluptuous dreams. But I re- 
mained without a companion and therefore without real en- 
joyment. (He has, however, on various occasions, experi- 
enced erections, and even emissions, on seeing by chance 
men or boys defaecate.) Hinc illae lacrimae, the excite- 
ment over my own defaecation, only took place faute de 
mieux. 

"1 knew very well that my thoughts and practices were 
impure and contemptible. Ah! how often, when the intox- 
ication was over, have I thrown myself remorsefully on my 
knees, praying to God for pardon! For some weeks I re- 
pressed my longing; but at last it was too strong for me, 
I tried to justify myself and fell into my vice anew. That 
1 was guilty of licentiousness and loved boys sexually first 
became clear to me later on, when I knew the significance 
of erection as a sign of sexual excitement. 



Erotic Symbolism. 



31 



"No one can imagine with what demoniacal joy I am 
possessed at the thought of a beautiful naked boy whose 
abdomen is filled as the result of long abstinence from 
stool. The thought powerfully excites me, a flood of pas- 
sion goes through my blood and my limbs tremble. 1 
never would grow tired of feeling that belly and looking at 
it. My passion would express itself in tempestuous ca- 
resses, and the boy would have to assume various positions 
in order to show off the beauty of his form, i. e. f to bring 
the parts in question into better view. To observe defae- 
cation would still further increase this peculiar enjoyment. 
If the boy's bowels were not sufficiently filled I would 
feed him with all sorts of food which produces much excre- 
ment, such as potatoes, coarse bread, etc. If possible I 
would seek to delay defaecation for two or three days, so 
that it might be as copious as possible. When at last it 
occurred, it would be an unspeakable joy for me to watch 
the dung — which would have to be fairly firm — emerging 
from the anus." 

X. would like to be a teacher and thinks he could ex- 
ert a beneficial influence on boys. In spite of the pain he 
has suffered, he does not think he would like to be cured 
of his perverse inclinations, for they have given him joy 
as well as pain, and the pain has chiefly been owing to 
the fact that he could not gratify his inclinations. X. 
smokes and drinks in moderation and has no feminine 
habits.* 

The case of coprolagnia communicated to me is tha 
of a married man, normal in all other respects, intellectually 
brilliant and filling successfully a very responsible position. 
When a child the women of his household were always in- 
different as to his presence in their bedrooms and would 
satisfy all 'natural calls without reserve before him. He 
would dream of this with erections. His sexual interests 
became slowly centered in the act of defaecation, and his 
fetich throughout life never appealed to him so powerfully 
as when associated with the particular type of household 



♦Moll, Kotitran SsxualemfinJunz, 3rd ed. p 



32 



Have lock Ellis. 



furniture which was used for this purpose in his own 
house. 

The act of defaecation in the opposite sex, or anything 
pertaining to or suggesting the same, caused uncontrollable 
sexual excitement; the nates also exerted a great attraction. 
The slime excreta exerted this influence even in the ab- 
sence of the woman; it was, however, necessary that she 
should be a sexually desirable person. The perversion in 
this case was not complete; that is to say that the excite- 
ment produced by the act of defaecation, or the excretion 
itself, was not actually preferred to coitus, the sexual idea 
was normal coitus in the normal manner, but preceded by 
the visual and olfactory enjoyment of the exciting fetich. 
When coitus was not possible, the enjoyment of the fetich 
was accompanied by masturbation (as in the analogous 
case of urolagnia in the woman summarized.) On 
one occasion he was discovered by a friend in a bedroom 
belonging to a woman, engaged in the act of masturbation 
over a vessel containing the desired fetich. In an agony 
of shame he begged the mercy of silence concerning this 
episode, at the same time revealing his life-history. He has 
constantly been haunted by the dread of detection, as well 
as by remorse and the consciousness of degradation, also 
by the fear that his unconquerable obsession may lead him 
to the asylum. 

The scatalogic groups of sexual perversions, urolagnic 
and coprolagnic, as may be sufficiently seen in this brief 
summary, are not merely olfactory fetiches. They are in 
a larger proportion of cases dynamic symbols, a preoccupa- 
tion with physiological acts, which by associations of con- 
tiguity and still more of resemblance, have gained the vir- 
tue of stimulating in slight cases and replacing in more ex- 
treme cases the normal preoccupation with the central 
physiological act itself. We have seen that there are 
various considerations which amply suffice to furnish a 
basis for such associations. And when we reflect that in 
the popular mind, and to some extent in actual fact, the 
sexual act is like urination and defaecation, an excretory 



Erotic Symbolism. 



33 



act, we can understand that the true excretory acts may 
easily become symbols of the pseudo-excretory act. It is 
indeed in the muscular release of accumulated pressures and 
tensions, involved by the act of liberating the stored-up 
excretion, that we have the simulacrum of the tumescence 
and. detumescence of the sexual process.* 

In this way the erotic symbolism of urolagnia and cop- 
rolagnia is perfectly analogous with that dynamic symbol- 
ism of the clinging and swinging garments, which Herrick 
has so accurately described, with the complex symbolism of 
flaggellation and its play of the rod against the blushing 
and trembling nates, or with the symbols of sexual strain 
which are embodied in the foot and the act of treading. 
(To be concluded.) 

*In the study of Love and Pain in a previous volume (p. 130) I have quoted the 
remarks of a lady who describes the analogy between sexual tension and vesi- 
cal tension. "Cette volupte que ressentent les bords de lamer, d 'etre toujours 
pleins sans jamais deborder"— and its erotic significance. 



NEURONES IN THE LIGHT OF OUR PRES- 



ENT KNOWLEDGE. 



By JOSEPH COLLINS, M. D., 

New York. 

Professor of Neurology at the New York Post-Graduate Medical 
School and Hospital, 

and 

EDWIN G. ZABRISKIE, M. D., 

New York. 

Instructor in Neurology at the New ^ ork Post-Graduate Medical 
School and Hospital. 

TPEN years ago the "Neuron theory," i. e. the theory 
* that the nervous system was made up of a collection 
of anatomical and genetic nerve entities or units constituted 
of cell, fiber and terminal ramifications, having no connec- 
tion save by contiguity, was generally accepted. In 1891, 
Waldeyer, the Berlin anatomist, set forth the idea of the 
neuron based largely upon the conception of Gerlach and 
Deiters and upon work that had I een done by means of 
the Golgi and Cajal methods of staining, which, as is well 
known, reveal particularly the outlines of nerve cells. He 
maintained that nerve fibers are collections of axis cylinders 
which emerge directly from nerve cells, that there is no 
relationship to a fiber network at the point of origin, and 
that all nerve fibers end free in terminal ramifications without 
anastomosis or network formation of any kind. The neuron 
theory seemed entirely to harm* nize with the cell theory, 
and the application of it to the problems of neuropathology 
seemed to divest many of them, particularly the systemic 
and combined systemic diseases, of their obscurities. In 

34 



Neurones in the Light of Our Present Knowledge. 



35 



short, it appeared to harmonize so well with physiological, 
histological, and pathological teachings that it soon became 
almost universally accepted. It is not our purpose to call 
particular attention to the wide application of the neuron 
theory to clinical medicine and to psychology, nor to the 
fact that in some instances it has been carried to an absurd 
degree. 

Gradually in latter years an increasing interest has 
developed in the histology and microchemistry of the ner- 
vous system; and with this has come from many workers 
in these fields a decided opposition to the neuron theory 
so that to-day it is in the strict sense partially or wholly 
rejected by many of the most trustworthy workers in the 
fields of neurohistology and biology. Apathy, Bethe, Nissl, 
and others have sought to establish that the fibrils of nerve 
cells form a continuous system, without beginning, without 
end, like the vascular system, binding one cell body with 
another and thus uniting the neurons between them. 
Without in any sense holding a brief for those who oppose 
the neuron theory, we propose briefly to review some of 
the more important evidence that now exists to show that 
the nervous system is not made up of a collection of units, 
of invariable constitution with free endings, having no 
connection with one another save by contiguity, and to 
attempt a judgment of the evidence thus reviewed. 

The temporal evolution of our knowledge of the nervous 
system falls into periods. The work that was done from 
1835 to 1885 — fifty years — and the work that has been done 
since 1885 — twenty years. 

After the discovery of the nerve cells by the zoologist 
Ehrenberg, and the study of them by Valentin, Purkinje, 
Wagner, and others, it was demonstrated by Deiters that 
nerve cells were made up of a cell-body and prolongations, 
protoplasmic and axis-cylinder prolongations, unlike in 
structure and behavior; the former being of the same con- 
stitution as the cell, split up soon after their origin, and 
terminate not far from the cell. The latter, of much more 
compact structure, were directly continuous, Deiters main- 
tained, as nerve-fibers. 



36 



Joseph Collins — Edwin G. Zabriskie. 



When Remak depicted axis-cylinders, or, as he called 
them, the "primitive bundles," he described them as finely- 
striated structures, but not distinctly fibrillated as did 
Fromann in 1864. The latter depicted fine fibrillary stria- 
tions in the cells of the anterior horns and in their proto- 
plasmic prolongations, especially distinct in the latter. The 
opinion generally held at that time by anatomists was that 
axis-cylinders or "primitive bundles" were homogeneous in 
structure and that their peripheral terminations, at least in 
case of muscle plates, were in ends external to or beneath 
the sarcolemma. 

In 1859 Lionel S. Beale, Professor of Physiology and 
Pathology in King's College, London (whose death was 
recently announced,) published an article in the Philosoph- 
ical Transactions (1860, page 611) in which he maintained 
that complete nerve circuits existed, i. e. that there was no 
free ending of nerve fibers anywhere. Nerve fibers, he said, 
passing to a muscle, divide into a vast number of exceed- 
ingly fine pale granular fibers which ramify upon the external 
surface of the sarcolemma, connected with which fibers at 
certain intervals are oval nuclei; and these fine fibers, after 
an extensive, and in many cases very circuitous course, 
join with other fibers to form dark bordered fibers which 
at length pass toward the nervous center either in the same 
bundle as the dark bordered fibers passing toward the mus- 
cles, or in other bundles. 

He prepared tissues for examination by soaking them 
in or injecting them with some highly refractive fluid such 
as simple syrup or glycerin to which a little chromic acid 
had been added. Beale did an enormous amount of work 
in support of his claims, published various articles, illus- 
trating them with excellent drawings, and offered to dem- 
onstrate his specimens to anyone who would take the trouble 
to look at them. He concluded from his work upon the 
different tissues of the body that nerve fibers never end or 
terminate by free extremities, but that in all cases complete 
circuits exist and that the circuit is the fundamental origin 
of the nervous apparatus. In other words, his position was 



Neurones in the Light of Our Present Knowledge. 



37 



almost identical with that of those who hold to the neuro- 
fibril theory of to-day. Beale was treated with scant cour- 
tesy by his contemporaries and apparently even that was 
accorded to him only because of personal friendship with 
some of the leading German anatomists. Kiihne, Kolliker, 
Margo, and Engelmann all denied the accuracy of his dia- 
grams and the reality of his descriptions, while some of the 
French anatomists, notably Rouget, essayed disdainfulness 
and superiority, saying: "It is easy to assure one's self that 
the description of Beale is wholly inexact and no time 
should be wasted upon it by the experienced and attentive 
observer." Time has shown that Beale was accurate to a 
degree that can scarcely be believed when one remembers 
that the only reagents that he worked with were syrup 
and glycerin. It is largely due to Joris, in his prize essay 
published by the Belgian Royal Academy of Medicine, 
"Nouvelles Recherches sur les Rapports Anatomiques des 
Neurones," that attention has been called to the remarkable 
work of Beale. In the hundreds of articles, monographs, 
and reviews that have been written on neurons and neuro- 
fibrils in the past ten years, Beale's name is not mentioned- 
For instance, Bethe, in the third chapter of his "Allgemeine 
Anatomie und Physiologie des Nervensystems," says that 
the fibrillary structure of the nerve cells and its prolonga- 
tions received its first great impetus from Schultze. In 
reality Schultze confirmed the discoveries of Beale while 
emonstrating the existence of isolated nerve fibrils and 
showing that they were specific elements of the nervous 
tissue. His article formed a chapter in Strieker's Handbuch 
der Geweblehre, 1871, which, being the most popular text- 
book of histology in the German language, was widely read 
and became very generally known. On the other hand, 
Beale's articles were published in the Philosophical Trans- 
actions, a vehicle rarely encountered by German savants, it 
would seem, and in the Archives of Medicine, of which he 
was editor. His position as a teacher, his membership in 
the Royal Society, h s repute as a master of microscopical 
technique, apparently did not help him to a serious hearing. 
That Beale was master of the situation, however, and that 



38 



Joseph Collins — Edwin G. Zabrishie. 



he believed firmly in his findings, can be proven to anyone 
who will take the trouble to read the article in the Archives 
of Medicine, Volume IV., 1863-1870, entitled "An Anatom- 
ical Controversy,* ! in which he deals with those who sat 
in judgment upon him in a most masterful manner.* 

There is no doubt whatsoever that Max Schultze extended 
Beale's ideas very materially, but Schultze had the advantage 
of examining cells of tissues that had been hardened in chrome 
salts, in iodized serum, and in osmic acid and bichromate 
of potash. Schultze showed that the "primitive bundles." 
as he called them, constituted the specific structural ele- 
ment of the nervous substance. He demonstrated the 
-distinct fibrillary striations which are entirely indepen- 
dent and parallel both in the protoplasmic and in the 
axis-cylinder prolongations. He pointed out that the 
non-medullated fibers split up at the end so as to form a 
bush -like condition of the finest fibrils. In ganglion cells 
treated with iodized serum he was able to see the finest 
striations and to trace these striations through the entire 
cell from one side where they came in to the other side 
where they passed out through other prolongations. In other 
words, he showed to his own satisfaction that the fibrils 
did not originate in the body of the cell. These discoveries 
led him to the conclusion that the fibrils were the essential 
thing in the construction of the nervous system, and that 
ganglion cells were no more than stations for the fibrils, 
which stations served to make it possible for fibrils coursing 
in a prolongation to get into connection with many other pro- 
longations and also with axis-cylinders. His idea was that 
the nerve fibers were simple fibrillary bundles, and he there- 
fore divided them into two classes — naked fibrillary bundles 

*In Vol. V. of the same journal will be found an unsigned article entitled 
"German Criticism and British Medical Science," undoubtedly from the pen of 
Dr. Beale, which throws an interesting side light upon the controversy: "It has 
been said that science is of no nationality. . . . Such dreams must be dispelled; 
Germany has spoken; the investigation of Nature's minutest and most delicate 
secrets is her prerogative only. Anatomical observations are made in Germany 
only, and it is not possible to discover any structure elsewhere. Other countries 
must expect and listen to the story of what she finds. To her alone belongs the 
right to discover! Nay, it is doubtful if light for microscopical illumination is to 
be obtained elsewhere." 



Neurones in the Light of Our Present Knowledge. 



39 



and fibrillary bundles with medullary sheaths. Despite the fact 
that this line of investigation was pursued with much success 
by other investigators, and notably by Kuppfer (who, by the 
way, Apathy states, was the real discoverer of the neurofibrils, 
Sitzungsber. d. Naturwissenschaft. Atlas d. Bayerish Acad. d. 
Wissensch. Med , 1883, page 473,) H. Schultze, Dogiel, Flem- 
ming, and many others, it was not until 1897 when Apathy 
made his contribution entitled "Das Leitende Element des 
Nervensystems und seine Beziehungen zu den Zellen" 
(Mitteilhungen der zoologischen Station, Neapel, Volume 
XII.), that neurofibrils began to have an important place 
in the literature of neurology and histology. In several 
communications dating back to 1883, he had pointe d out 
the fundamental facts of his observations and conclusions, 
but these were published principally in the Hungarian 
language and were unnoticed In the volume that ap- 
peared in 1897 the pen pictures and verbal descriptions 
were so distinct and comprehensive that at once the mat- 
ter was given the attention which it demanded. He main- 
tained that the neurofibril is the essential and specific 
constituent of the nervous system. He had studied in de- 
tail the nervous system of the leech by the aid of a 
method, now well known, which depicted the nerve fibrils 
with such distinctness that they could be followed from 
one end of the preparation to the other. These neurofibrils 
appeared as deep dark threads on a slightly tinged back- 
ground, or, as Bethe says, like telegraph wires against a 
clear sky. On cross-section of sensory or motor fibers 
they appear as dark spots or small, somewhat spiral lines, 
indicative of their spiral course. 

These neurofibrils were found wherever there was 
nerve organization, i. e. in nerve fibers, in ganglion cells, 
in sensory epithelial cells, in glandular cells, and in all 
these tissues they were sharply differentiated. There was 
no vagueness about their outline, they were well- 
defined, individual morphological elements and nowhere 
could an ending of one of the neurofibrils be found. 
Apathy believed the individuality of the neurofibril, the un- 
interrupted course, and the endlessness to be its most striking 



40 



Joseph Collins— Edwin G. Zabriskie. 



features. In end organs, such as muscle fibers, sensory 
epithelial cells, glandular cells, etc., the fibrils interlace so 
as to form networks. In ganglion cells they seem to term- 
inate in a similar way. The majority of the fibrils which 
enter ganglion cells through the protoplasmic prolon- 
gations of unipolar cells or through the many prolonga- 
tions of the multipolar cells, interlace in such a fashion as 
to form a very intricate network. A similar network form- 
ation is found in the neuropil (the nerve cell in contra- 
distinction to the ganglion cell), only the very fine net- 
work occupying the center of the cell, is made up of very 
many more fibrils. Conducting primitive fibrils pass into 
the interior of the ganglion cell, and just as many element- 
ary fibers leave it after the "trellis formation. " Termina- 
tion, dissolution in or connection with the cell nucleus the 
fibril does not have. 

In this conception of Apathy, the neurofibrils either go 
toward centers and penetrate ganglion cells, or they go to- 
ward the periphery and ramify around muscle cells and 
penetrate sensory or secretory cells. In invertebrates 
Apathy demonstrated motor fibers which extend from the 
cell to the muscle to which they go, and sensory fibers 
very much thinner than the motor which pass into the 
"elementary trellis* * and from there into the cell. Apathy di- 
vides the cells of the nervous system into two distinct classes — 
nerve cells and ganglion cells. The former are analogous to 
muscle cells; they produce the material that conducts, f. e. 
the material that produces fibrils. 

The ganglion cells are interpolated in conductive paths like 
cells in an electric circuit; they produce that which is to be con- 
ducted. In ganglia these ganglion cells are arranged around the 
periphery and are of two kinds, large and small. Neurofibrils 
entering the large cells form at once an intramedullary net- 
work and from this network new fibrils detach themselves 
and go out through the same prolongation. Thus a pro- 
longation conducts in two directions. Primitive fibrils may 
pass through a number of ganglion cells before they enter 
into the formation of networks. In the prolongation of the 



Neurones in the Light of Our Present Knowledge. 41 




Fig. i. — Apathy's Schema of course and communication of the con- 
ducting pathw ay in cross-section of a cornite of Hirudo. The two gan- 
glion valves with motor mg, and sensory or merely connecting gst ganglion 
cells. The three kinds of nerve spindles or nerve fibers sb, sschl, mns, their 
arrangement in the center, distribution in the central mass of fibers and 
connections with the ganglion cells; their arrangement at the periphery: 
muscle fibers, epidermal and subepidermal sensory cells with their 
terminal branching in its epidermis (fre), usschl wh^re a sensory tube sbq, 
where a sensory bundle curves into the central mass of fibers in a longi- 
tudinal direction, tnbe conducting bridges between muscle fibers. We see 
from the upper right the perceptive sensory surface, the centripetal con- 
ducting febril path, which enters into the elementary gutter and thence 
in the ganglion cell and its mesh work. Thicker fibers which later 
become united in bundles as the motor nerves pass from the motor gan- 
glion cells to muscle (lower right) and branch in the manner already 
described. — (From Hartmann, "Die Neurofibrillenlekre.* > 



small cells there is to be found an individual fiber which is 
characterized by its considerable volume: this is the motor 
fiber. All fibrils coming out from ganglion cells enter the 
formation of a common network occupying the center of 



42 



Joseph Collins — Edwin G. Zabrishie. 




Fig. 2. — B elementary network of Golgi net, from which the 
neurofibrils develop and pass into the cell. The same at M N with the 
fibrile. L elementary fibers passing from the nervous gray into the 
Golgi net. A nervous gray; C axone hillock without Golgi net. X 
axone; H myeline sheath; I K connection of axone with nerAous grey 
after Nissl. 



Neurones in the Light of Our Present Knowledge. 43 

the ganglion. This common network is the "elementar 
i gitter" of Apathy, or, as it may be translated, elementary 
; trellis or screen. In some instances fibrils come directly 
from^the cell without passing through this central network. 

At the periphery of the body there is a very similar dis- 
position of the nervous element. The neurofibril forms in 
the secretory cell an intracellular network, whose branches 
leave the cell and anastomose with fibrils coming from 
neighboring cells to form intercellular networks. 

In 1896 the teachings of Apathy were accepted by 
Bethe, who confirmed his findings in invertebrates by the 
use of other methods of investigation. Extending Apathy's 
conception, Bethe attempted to show that in the phyloge- 
netic development of animal life, so called plasmatic nerve- 
nets constitute the lowest method of connection of nerve 
cells. The fibrils of these plasmatic networks form only the 
intercellular trellis which constitutes the direct connection 
between the peripheral sensorium and the muscles. In the 
nervous system of all higher animals there occurs some- 
where a mixture of the fibrils coming anywhere from the 
surface which make up the fibril trellises, and, according to 
Bethe, it is the position of this trellis which constitutes the 
difference between the different forms. 

As we ascend in the scale of the vertebrates we find 
that the fibril gets more and more outside the cell, until 
finally it gets entirely out between the cells, so that accord- 
ing to Bethe's view, within cells fibrils merely pass through 
having no more intimate relation than that caused by such 
passing. Either the fibril trellises remain near each other 
and have long pathways to receptory and effectory organs, 
I or long pathways form between remote fibril trellises. Recent 
work done according to the methods of Cajal and Biel- 
chowsky seems to corroborate in general Bethe's opinions, 
but it is difficult to obtain reliable information of the fibrils 
in central cells with these methods. Apathy maintains 
that there is an intercellular trellis formation in vertebrates. 
Hartmann (Die Neurofibrillenlehre, Braumiiller, Vienna and 
Leipzig, 1905) is inclined to accept this inasmuch 



44 



Joseph Collins — Edwin G. Zabrishie. 



as his preparations showed that a part of the fibrils 
which pass into many ganglion cells have a trellis forma- 
tion which, in the large pyramidal cells, for example, lies 
near the basal part of the cell; in the smaller cells this 
takes up nearly the entire cell. 




-Fig. 3. — Large multipolar cell from the reticular formation of the 
medulla of a rabbit. (Cajal method.) 

In addition, fibrils in variable numbers go from dendrite 
to dendrite and from axis cylinder to dendrite through the 
cell without perceptible relation one to another. 

Bethe also found by his method that ganglion cells of 
vertebrates are surrounded by a close-meshed net-form trel- 



Neurones in the Light of Our Present Knowledge. 



45 



lis which he calls the Golgi net and which he believes is 
of nervous nature. 

He has framed an hypothesis concerning the transmis- 
sion of the nervous current from this network to the cell 
and to the dendrites. The dendrites, i. e., the protoplas- 
mic processes, of the cells end blind. Probably the fibrils 
pass into Golgi nets and unite with the fibrils which pro- 
ceed from the splitting up of the centripetal nerve fibrils 
to form network formations as in invertebrates. 

Nissl agrees that the Golgi net is a new important 
structural element of the nervous system, but he does not 
believe that the neurofibrils go out from the protoplasmic 
prolongations unchanged into the terminal endings of the 
centripetal medullated fibers. This Golgi network Bethe 
finds at the surface of all the cells of the central nervous 
system. In the cerebrum, cerebellum, Amnion's horn, and 
in the gelatinous substance it extends diffusely. In other 
regions such as the motor nuclei, the dentate nucleus, the 
olives, etc., it confines itself to the surface of the cell, but 
where two cells or two dendrites touch the Golgi network 
reaches from one directly to the other. It is limited to the 
gray matter. It does not seem to have any relationship to 
the vessels, the neuroglia, or the pia. But the nervous na- 
ture of this Golgi network, unfortunately for Bethe's theory, 
has not been proven. Cajal, Lugaro, Donnagio, Marinesco, 
and others maintain that this network represents nothing 
else than artificial coagulations of certain albuminoid sub- 
stances in the interior of vessels. Nissl changes Bethe's 
hypothesis so that the neurofibrils of the cell border and in 
the terminal ramifications undergo a change which permits 
their colorability, a condition previously impossible. 
(See Fig. 2.) 

Bethe's conclusion is that the nerve fibril is a multi- 
cellular formation in which the ganglion cells and the end 
organs are united by neurofibrils, the ganglion cells them- 
selves being of slight functional value. The neurofibrils are 
the essential specific constituent of the nerves and they are 
the nerve substance in general. Engelmann's opinion that 



46 



Joseph Collins — Edwin G. Zabtiskie. 



the axis cylinder section of medullary substance and the 
nucleus of Schwann, situated between two nodes of Ran- 
vier may be looked upon as a cell, it has been thought, 
has received corroboration from Bethe, who found, he main- 
tains, that at Ranvier's nodes the fibrils alone pass through 
a sieve-like membrane. This, he thinks, fortifies the opin- 
ion that these constitute the confines of the cell. Retzius 
insists that at the above-mentioned places not only the 
neurofibrils but also the perifibrillary substance is seen 
to pass through, that the number of the neurofibrils and 
also the perifibrillary substance is decreased, therefore a 
rarefaction of the entire substance of the axis-cylinder 
takes place at the nodes of Ranvier. 

Nissl maintains that the complex called a neuron is not 
the sole nerve element. There are cellular elements which 
do not have their origin from ganglion cells, and there is a 
specific tissue of as yet unknown texture lying outside the 
cells, the so-called "nervous gray." (Fig. 2.) This sub- 
stance is of a fibrillary nature. According to him, dendrites 
as well as axis-cylinders terminate blind in this gray sub- 
stance. Therefore, something must exist which is inter- 
polated between the end of the axis-cylinder which is 
synonymous with the cessation of the medullary sheaths, 
and the Golgi nets and the nerve cells situated in the vi- 
cinity of the axis-cylinder termination. This is the ner- 
vous gray. He has never been able to demonstrate it, but 
he has attempted to show mathematically that this ner- 
vous substance must exist. He says that if the demon- 
strable cortical elements are added together a large portion 
of space remains unoccupied, but the work of Beilchowsky 
and Wolff on the cerebellum by the use of the former's 
silver method which impregnates neurofibrils and plasma 
with a remarkable clearness and which demonstrates the 
continuous transition of axis-cylinder fibrils and closely 
united peri- and intracellular nets, would tend to upset 
this. 

Ansalone has pointed out (Contributo alio studio delle 
Neurofibrils nella midolla spinale dei vertebrati superiori, 
Annali di Neurologia, Ann. XXII., fasc 3, 1904) that the 



Neurones in the Light of Our Present Knowledge. 



47 



neurofibrils of the cells in the spinal cord vary in appear- 
ance according to the region of the cell which is under in- 
spection. The prolongations also present very variable 
pictures. In the peripheral portion of the cell there is no 
network in the proper sense of the term, the neurofibrils 
running in the shape of thick cords from one pole to the 
cell to the other, without dividing or anastomosing. The 
cellular element is not at all differentiated from the surrounding 
tissue; and it stands in connection with fine fibrils which 
reach it in a direction nearly perpendicular to that of the 
neurofibrils. In the deeper regions of the cell the neuro- 
fibrils form a network, the communications of which with the 
nucleus vary according to the section plane of the cell. The 
fibrillary network may either cover the nucleus completely, 
presenting a greater condensation and a finer quality of 
mesh at this level, or it may pass over it like a bridge 
in the form of more delicate threads. Again, it may be 
strictly limited to the nuclear outlines where it terminates. 

Schaffer, who has recently published a paper on the 
subject (Recherches sur la structure dite fibrillaire de la 
cellule nerveuse, Revue Neurologique, No. 21, 1905) comes 
to somewhat different conclusions. The author investigated 
the finer fibrillary structure of the nerve cells in the spinal 
cord, the oblongata, and the pyramidal cells of the cortex 
and concluded that there are, two systems of reticular 
structures in the nerve cells; first, a pericellular external 
network with thicker meshes at the periphery of the cell- 
body and in the protoplasmic processes, which is identical 
with Golgi's net; the beams of this network which repre- 
sent a sort of cortical substance of the cell, form the mesh- 
work of the cell process also, which become more plainly 
outlined in the presence of swelling from the general paral- 
lell arrangement of the fibrils. All the fibrils of the cell- 
body as well as the processes anastomose with each other 
and the fibrillary cellular structure is therefore really a 
pseudofibrillary structure of a reticulai character, although 
presenting a parallel striped appearance in certain locali- 
ties. Another net is formed by fine fibrils, which form a 
polygonal wide meshwork, by branching off from the cross- 



48 



Joseph Collins — Edwin G. Zabriskie. 



beams of the first net towards the interior. This internal 
reticular system appears denser around the nucleus; it also 
sends its prolongations into the protoplasmic processes. The 
internal and the external intracellular network stand in 
close connection with each other. The author finally ob- 
served extracellular fibrils which approach the cell- body in 
a Y-shaped oblique direction, or parallel to the pericellular 
network, blending with the body. The Y-shaped branch- 
ing of the fibrils he also considers with Bethe as suffi- 
cient proof of the existence of an endoce lu ar network. 

Donnagio, working with an original method (Anatomia 
e fisiologia delle vie di conduzione endocellulari Atti del 
XII Congresso della Societa freniatrica, Ital. in Riv. speritn. 
di Fren., Volume 31, T. 1, 1905), concludes that "the exis- 
tence of a network of fibrils in the ganglion cell, besides 
the long fibrils which traverse the cell chiefly at the 
periphery, must be accepted as conclusively proven. 
It still remains doubtful whether or not these long 
fibrils anastomose with each other." According to struc- 
ture, two types of ganglion cells may be distinguished: 
Cells containing only a network of fibers, and cells con- 
taining long fibrils in addition to a network. The axis- 
cylinder receives fibrils from the network principally. 

That endocellular nets exist has been demonstrated 
again and again but whether this is always true or that 
Donaggio's conclusions are certain, is by no means defi- 
nitely established. Fig. 3 gives a fair representation of 
one of our own specimens, and as can readily be seen, 
there is no evidence of an endocellular network. Fig. 4, 
on the other hand shows one of the horizontal cells from 
the retina, with an indisputable perinuclear net. We have 
also seen undoubted net formations in the reticular cells of 
the tegmentum and corpura quadrigemina. Although the 
observation of others and that we ourselves have seen 
would tend to support the view of independence of the axome 
fibrils from those of the dendrites, still we cannot accept, 
at least from the evidence offered, the views of Schaffer 
regarding the fine fibrillary network of the cell body and 



Neurones in the Light of Our Present Knowledge. 



49 



dendrites in contra- distinction to the perinuclear and 
axonal meshes. He practically rests his case on the Y- 
shaped branching, which, when we stop to consider that 
we are dealing with almost ultra- microscopic structures, 
and therefore exposed to many possibilities of error, are 
altogether too uncertain to be of such fundamental value. 

The relationship existing between cell fibrils and axis- 
cylinder fibrils is still a matter that requires very great 




Fig. 4.— Horizontal cell from retina of cat of eight days. A ax- 
one; B perinuclaar network. (After Cajal.) 

elucidation. Held and Wolff maintain that they have seen 
fibrils leave the terminations of the axis-cylinders and enter 
the body of ganglion cells, by means of Cajal's method and 
Bielchowsky's method respectively. Mahaim studied the 
nervous system of the cat, the crow and the human sub- 
ject, by the various Cajal methods. He did not in a single 
instance observe fibrils penetrating into the cell body. He 
is of the opinion that Wolff's reticulum is the result of 
faulty technique; this is not, however, true, for the rela- 



50 



Joseph Collins — Edwin G. Zabriskie. 



tively thick fibers which Held saw penetrating the cell. 
The author believes that this is an anatomical "semblance, " 
for the experimental methods show by chromatolysis the 
marked difference existing between sections of axis-cylin- 
ders arising from a cellular nucleus, and sections of axis- 
cylinders penetrating into a nucleus. The relation between 
the pericellular terminations and the body of the cells can- 
not, therefore, be very intimate; and it may be stated that 
these terminations "are not a part of the cells. " The au- 
thor hopes that it will prove possible by means of appro- 
priate experimental methods to observe degenerated peri- 
cellular masses surrounding an intact cellular body. 

Bartels, studying the fibrillary structure of the ganglion 
cell layer of the retina by means of Bielchowsky's fibril 
method, maintains that he has succeded in demonstrating 
the presence of fibrils which pass from a protoplasmic pro- 
cess through the cell and into the axis-cylinder process. 
He also observed other fibrils passing from one dendrite into 
the other, without traversing the cellular body itself. Fin- 
ally fibrils were noted connecting the processes of different 
cells. On the other hand, Vermes (Ueber die Neuro- 
fibrillen der Retina, Anat. Ang., Volume 26, Heft 22-23, 
1905), who studied the retina of the horse, dog, rabbit, cat, 
guinea-pig, and also of the human subject by means of the 
Cajal and Bielchowsky fibrillary methods, does not consider 
that the continuity of the neurofibrillary layer has been 
demonstrated. Ramon y Cajal (Trabajos del Laborator de 
investigacion biol. de la Universidad de Madrid, III., 4, die. 
1904) shows that the differentiation of the fibrils in the 
cells of the retina begins within the plasma zone from 
which the dendrites arise, and they begin with the begin- 
ning of function; they are begotten by function from the 
cell protoplasm. 

The field in which the question of contact or contin- 
uity has been most hotly contested, however, is that of 
the terminal arborizations of axone at fibrils about the cells. 

The recent investigations of Cajal, Bielchowsky, Holm- 
gren, Michotte, and others, show that the neurofibrils ap- 



Neurones in the Light of Our Present Knowledge. 



51 



pearing on the surface of the cell come in contact with it 
by means of bulbous formations known as the terminal 
buttons. Bielchowsky, Held and Holmgren believe that the 
terminal buttons are fibril net- like structures and that the 
fibrils of the buttons pass into the interior of the cells. 
But the terminal buttons are in intimate relationship on 
the surface of the cell through anastomosing fibrils which 
form a close network. Bielchowsky holds that this form- 
ation is identical to that which Held calls the pericellular 
Golgi nets. 




Fig. 5. Multipolar cell with terminal buttons (Cajal method.) 

Cajal divides the terminal buttons, or terminal masses, 
asThe calls them, which were discovered by means of his 
method into two forms, the end club and the transition 
club. The former come from the vicinity of the cell in 
form of a fine thread which swells up as soon as it reaches 
the cell body and closely hugs the cell membrane or the 
dendrite with its basis. The transition form are fusiform 
thickenings of certain fibrils, which also become applied to 
the cell membrane. The end-clubs are found in large 
numbers at the cell body, sometimes giving it a mottled 
aspect like a tiger skin. They are never absent at the 



52 



Joseph Collins — Edwin G. Zabtiskie. 



dendrites. Only isolated end-clubs occur at the root cone 
of the axis-cylinder. VanGehuchten and Marinesco have 
corroborated (Boutons terminaux et reseau pericellulaire, 
Le Nevtaxe, Volume VI.) these observations of CajaFs. 

In specimens prepared according to CajaFs method, 
these end-clubs were observed to be independent of each 
other as well as of the cell. Cajal's method being an elec- 
tive nerve fibril method, the pericellular nets, if they exist 
at all, can only consist of protoplasmic substance. Fig. 5. 

Held (Zur weiteren Kenntniss der Nerven-endfiisse und 
zur Structur der Senzellen. Abh. der K. Sachs. Ges. d. 
Wiss. Mat. Phys. Ll. No. 2, Volume 29, 1903-1904) found 
nets in the ganglion cells by means of Cajal's method. He 
disagrees with Cajal concerning the connection of the so- 
called terminal feet or buttons, and shows by photographs 
of his preparations that the terminal buttons are in con- 
tinuity with the protoplasmic substance of the cell body; 
and that the fibrillary net which exists in the term- 
inal button communicates with that of the cell. Hence the 
terminal buttons really constitute connecting links between 
locally remote ganglion cells of the central nervous system, 
in the longer or shorter path of their axis-cylinder pro- 
cesses. But, as we have said above, Held's views in this 
matter have not been accepted, neither have they been 
corroborated by acceptable investigators. 

Fig. 5 shows fairly well the formation of these termi- 
nal buttons as they appear in Cajal preparations. No 
single plane, however, such as the drawing must neces- 
sarily represent, can give an adequate idea of the enor- 
mous number which literally cover the cell and dendrites. 
This and other preparations which we have carefully 
studied, seem to bear out Cajal's views very forcibly, in as 
far as we have been quite unable to demonstrate fibrils 
passing from the end feet into the interior of the cell. 
Even successful Bielchowsky preparations, or the illustra- 
tions of Wolff, do not establish the continuity question 
firmly enough in our estimation to make their position sure. 
One should not forget that we are dealing with very 



Neurones in the Light of Our Present Knowledge. 53 

minute structures only to be seen with very high magnifi- 
cation, and there is such a dense network of similar 
structures that it becomes quite impossible to determine 
absolutely their ultimate destruction. 

The more important communications that have appeared 
during the past few years on the subject of the disposition 
of the neurofibrils of the periphery of the body must now 
be briefly reviewed. 

Ruffini (Ultraterminal Neurofibrils in Human Motor End- 
plates. Rivista di Fathologia nervosa e 'mentale, Firenze, 
October, 1900. Vol. V. Fac. X) states that he reexamined 
his old gold-chloride specimens of human motor endplates 
with the result that certain details were discovered, which 
lead him to believe that in man as well as in lower animals 
a closed system of anastomoses may originate from the 
motor ramifications (as discovered by Apathy in Hirudinea.) 
It is quite possible, he believes, that sensory nerve fibrils 
enter also in connection with this anastomotic system. 
Ruffini noticed that extremely fine fibrils, of variable length 
supplied with small "varicosities" sometimes originate from 
the endplates. These "ultraterminal fibers" seem to ter- 
minate after a longer or shorter* course within the same 
muscle-fiber, or more commonly in an adjacent muscle-fiber, 
either with a varicosity or without one. Occasionally the 
fibril terminates in a small secondary endplate, from which 
another thin fibril may take its origin. This goes to show 
that in man the so-called "motor endplates" are not the 
real termination of the motor nerve fibers; since other fine 
fibrils arise from them, the fate of which cannot be defi- 
nitely determined. 

Apathy, in discussing this communication limits himself 
to some very general theoretical considerations upon the 
importance of this fact as an argument against the neuron 
theory. He says that Ruffini's preparations afford proof 
that nerves do not terminate (or at least, do not invariably 
terminate — he, for his part, believing that they never do) 
in the endplates of the muscle; just as in the Hirudinea 
they do not terminate in the "terminal crests" described 



54 



Joseph Collins — Edwin G. Zabriskie. 



by him and which correspond exactly to the motor-plates 
of vertebrates. In vertebrates also, and in a very superior 
vertebrate at that — exceedingly fine nerve paths emerge from 
the terminal plate, passing in various directions through the 
muscle-fiber, branching and entering into adjacent muscle- 
fibers, just as they behave in the Hirudinea. 

If it is permissible to judge from experiments made 
upon animals of such "inferiority," Apathy continues, his 
observations lead him to predicate the probable ulterior fate 
of the ultraterminal branches in the following fashion: In 
part they may pass through some neighboring muscle fibers 
— in their way as yet unseen — and in part they branch 
immediately in the interstitial substance between the muscle- 
fibers, becoming isolated elementary fibrils. These elemen- 
tary fibrils then pass to the elementary peripheral net which 
spreads its large and uneven meshes in the interstitial 
substance between the muscle fibers. But the elementary 
net receives in its turn other elementary fibrils which come 
both from other motor plates, and from nonmotor nerves, 
from the nerves of general nonspecialized sensation (here 
perhaps from the nerves of muscular sense.) It is another 
question, which nerves, in vertebrates, are those nerves of 
general sensation. In the Hirudinea, Apathy was recently 
able to recognize those nerves in a special type of nerves 
described by him in 1897, and designated as "sensory tubes." 

Dogiel (Der fibrillare Bau der Nerven End-Apparate in 
der Haut des Menschen, und der Saugethiere; und die 
Neuronen-Theorie. Anat. Au^. Vol. 27, Nos. 4-5, 1905) 
describes the termination of neurofibrils in tactile disks, the 
typical and modified Vater-Pacini corpuscles, the typical 
and modified Meissner corpuscles, and the papillary bundles 
of Ruffini, with the assistance of specimens obtained by 
means of Cajal's neurofibril method from the human skin 
and from the skin and mesentery of the cat. He concludes 
that all sensory end-ramifications consist of more or less 
small-meshed and completely closed nets of neurofibrils, 
which are placed in a larger or smaller mass of perifibrillary 
substance. The shape alone varies in the individual end- 



Neurones in the Light of Our Present Knowledge. 



55 



apparatus; round, sometimes curved, small disks of variable 
diameter (tactile disks, Grandry's corpuscles, swellings at 
the axis-cylinder ramifications of the typical and modified 
Meissner corpuscles,) angular scales (human skin, tree-like 
terminations of sensory nerves of the cutis, mucous and 
serous membranes, intermuscular connective tissue, tendon); 
fusiform, club-shaped, round or oval, sometimes flattened, 
formations (Herbst corpuscles, typical and modified Vater- 
Pacini corpuscles.) The neurofibril nets are either in direct 
contact with their surroundings (connective tissue, fibril 
bundles,) or with special cells (tactile disks) or they have 
a special sheath. The most marked difference lies in the 
number of neurofibrils constituting the aggregate of all nets 
together, in which terminate the processes of a sensory 
cell, not in the shape of the terminal apparatus. These 
either reunite by means of individual neurofibrils, or by means 
of twigs consisting of several neurofibrils; all, together, or 
a certain portion, forming other end-nets in such a way 
that the individual terminal apparatus seems to be connected 
with its fellow (tactile disks, Grandry's corpuscles, leaf- 
shaped terminations, tree-like ramifications.) All the neuro- 
fibrils of a peripheral process stand in direct communication 
with the intracellular net; the perifibrillary substance con- 
tinues to the process, together with all its terminal nets, 
where it reaches the maximum amount, as that portion of 
the cell body which is not differentiated into fibrils. The 
central process differs in no important feature from the 
behavior of the peripheral process; the small, club-shaped 
thickenings, with which the terminal ramifications rest upon 
the motor cells and their dendrites likewise consist of closed 
nets of this character. The neurofibrils do not, however, 
enter into organic connection with the intracellular net or 
the undifferentiated protoplasm; simply resting immediately 
upon the cell. Each sensory cell represents a neuron, which 
communicates neither with other cells of the central nervous 
system, nor with other units. The neurofibrils belonging 
to a neuron, form at least three, closed and firmly united 
nets: the intracellular, the peripheral, and the central net. 
Cell colonies exist beyond a doubt in the central nervous 



56 



Joseph Collins — Edwin G. Zabriskie. 



system, meaning that cells of the same type unite by 
means of their dendrite ramifications. According to their 
function the closed terminal nets rest either upon the body, 
or the dendrites, of another colony, or of an individual 
neuron, or upon non-nervous elements (muscle cells.) 

In contradistinction to the Apathy-Bethe neurofibril 
theory, the author points out that the neurofibrils are to 
be interpreted simply as products of the differentiation of 
the nerve-cell protoplasm, and that they serve to build all 
the terminal apparatus and ramifications, assisted by a 
portion of the non-differentiated plasm, the perifibrillary 
substance. The different psychomotor and psychosensory 
functions belong not only to the neurofibrils, but also to 
the nerve cell, and all its parts. It is not at present 
possible to pronounce upon the function and importance of 
the neurofibrils. 

Kiomer, working on the crista of the mouse ("Zur 
Kenntniss des Verhaltens der Neurofibrillen an der Peri- 
pherie," Anat. Anz., Nos. 16-17, Vol. 27, 1905,) says the 
fibrils are seen to approach the cells, entering to a moderate 
degree into plexus- like ramifications. They then penetrate 
into the cell at the lower pole, and diverge in shape of a 
ball, sometimes dividing into branches. The interior of the 
cell presents a trellis of narrow meshes, which is especially 
dense directly toward the base of the nucleus. Imperfect 
staining with methylene blue and Golgi results in the pic- 
ture of the so-called terminal calices. The fibrils are seen 
to traverse the cells of the spinal ganglion with a distinct 
trellis formation, after which they pass to the habenula 
perforata. Especially in embryos (rodents and mice,) nuclei 
may be seen very plainly enclosed by very fine neuro- 
fibrils. At their egress from the habenula the fibrils diverge 
at blunt angles. From this point on, fibrils begin to pass 
in a spiral, rarely in a radiating direction, to the basis of 
the innermost cells. The others pass in regular flexions of 
approximately a right angle toward the three outer spiral 
fiber columns, in such a manner that the fibrils which pass 
to the first column present one flexion, those passing to 



Neurones in the Light of Our Present Knowledge. 



57 



the second two, and those passing to the third three flexions. 
From the fibrous strands the fibers run upward in a curve 
to the bases of the outermost cells, and enter the cell, 
forming a very fine trelliswork in the basal portion especially. 
Free nerve terminations could not be made out at all. The 
author points out that the behavior of the nerves varies 
surprisingly in the crista aud macula of different animals. 
The neurofibrils in the Pacinian body are rather numerous, 
the perifibrillary substance staining deeply and forming a 
distinct plate at the peripheral end, under which lies a 
small trellis of neurofibrils with distinct meshed formation. 
Concerning the effectory terminations, the author assumes 
a similar structure, supporting his views by the description 
and illustration of motor endplates and the intracellular ends 
of the glandular nerves from the skin of amphibia. The 
author was unable to discover special terminations in the 
myocardium, the fibrils invariably returning to form strands 
of parallel fibers, however fine they may have grown before. 
Neurofibrils do not occur anywhere without being accom- 
panied by their matrix, the perifibrillary substance, which 
may be either the protoplasm of a nerve cell, of a receptory 
or effectory cell. Both plasma and fibrils are capable of 
conducting, perhaps to a different degree, just as special 
contractile fibrils still occur in contractile protist plasm. 

Schiefferdecker (Nerven und Muskelfibrillen, das Neuron, 
und der Zusammenhang der Neuronen. Sit^ungsbericht der 
Niederrheinischen Ues. fur Natur-Heilkunde, Bonn, December 
12, 1904) observed that not only do the fibrils increase in 
size during the contraction of a muscle fiber, but also the 
strips of sarcoplasm between them, the latter contracting 
more strongly than the former. Accordingly the sarcoplasm 
can no longer be considered as an indifferent substance in 
the muscle fiber. The conditions existing in the muscle 
fiber resemble those of the nerve fiber and nerve cell* 
Here neither the fibrils nor the plasm serve independently 
for conduction; but the entire nervous activity is to be 
interpreted as a chemical or chemicophysical process, resulting 
from a mutual action of the plasm upon the fibrillary sub- 
stance. The chemical interaction increases in direct ratio 



58 



Joseph Collins — Edwin G. Zabriskie. 



to the surface of the fibrils. Accordingly, the intensity of 
the process constantly decreases from the cell-body toward 
the nerve termination. The author suggests a number of 
new terms. The indifferent protoplasm becomes "myo- 
plasm" as soon as the cell is plainly recognizable as a 
muscle cell, and it gradually matures into "sarcoplasm" 
with the formation of fibrils. In a corresponding fashion 
it is permissible to speak of successive "protoplasm," 
"neuroplasm," and "myoplasm," in the evolution of nerve 
cells. To the axoplasm and the axofibrils of the axis-cylinder 
correspond the teloplasm, and the telofibrils in the nerve 
termination. 

The alterations caused by experiments and by disease 
have laterly been carefully studied. These investigations 
have been directed mostly along two lines, namely: the 
changes occurring in the neurofibrils within the cells under 
abnormal conditions and those which take place in the 
peripheral nerves after resection and during regeneration. 
Marinesco {Revue Neurologique, p. 5, 1905) studied by 
Cajal's fibril method the cells of the twelfth neuclei after 
cutting the nerve, and noted during the first stages of 
reaction and reparation disappearance of the fibril network, 
the fibrils arranging themselves in bundles or in streaks. 
Later the net makes its reappearance centrally around the 
nucleus, with simultaneous thickening of the fibrils (increase 
of the reduction capacity of the fibrils.) Marinesco saw 
similar pictures in the spinal ganglion cells after section of 
the sciatic in rabbits, only in this case the changes occurred 
earlier and disappeared later. 

According to Cajal, in the hungry, resting hirudo and 
in resting animals while digesting, the fibril apparatus is 
very thick. The fibrils are thin when one warms the 
animals and immediately after they eat. If the animal 
starves the fibrils are destroyed and in part reabsorbed. 

Tello (Trabajos del Laborator de investigacion Biol, de 
la Universidad de Madrid, III, 2-3, p. 113, 1904) says that 
in the lizard, during its winter sleep, the disposition and 
the number of fibrils are very unlike those in the lizard 
during its activity. 



Neurones in the Light of Out Present Knowledge. 



59 



In the hibernating adder and the lizard, the fibrils in 
the cell are enormously thick. They stretch themselves 
out in the spring to extraordinary fine threads, and all 
transitional states may be seen in one cell. One never 
fails to see in these animals the passage of fibrils out from 
the cells; they go only in the dendrites and the axis- 
cylinders. 

It would seem that in these lower vertebrates, as 
in Hirudinea, the perinuclear fibril apparatus is the most 
mighty. Fig. 6. 

Ramon y Cajal ("Variations Morphologiques du Reti- 




Fig. 6. — Funiculear cell from medulla of rabbit; death by rabies. 
A swollen neurofibril. After Cajal 

culum Neurofibrillaire dans certains Etats Narmaux et Path- 
ologiques," Comp. rend, de la Soc. de Biol., LVI, 8, p. 
372, 1904) shows that the fibrils do not all behave in the 
same way. The ganglion cells in the cord of the hiber- 
nating lizard show definite changes in the neurofibrils when 
exposed to heat. They become finer, more abundant and 
lose their bundle formation. The terminal buttons remain 
unchanged. 

The condition of the neurofibrils in the brains of cases 



60 



Joseph Collins — Edwin G. Zabriskie. 



of general paresis have been studied considerably. Jansky 
("Neurofibrils Under Normal and Pathological Conditions," 
Casopais lek., 1905) shows that the structure of the neuro- 
fibrils is definitely altered in progressive paralysis. The 
findings consist in hypertrophy, varicosity, granular trans- 
formation, and refraction of the fibrils, more especially in 
the smaller ganglion cells. Nothing of special interest could 
be made out in a case of senile dementia; while in another 
case of catatonic dementia prascox of several years' duration 
the histological examination yielded the following results 
only: A distinct, diffuse chromatolysis seen by the Nissl 
stain, the silver impregnation showing apparently normal 
conditions. The same striking difference was observed in 
another case of dementia, in which also a marked chroma- 
rolytic change in the cells accompanied an unaltered struc- 
ture of the fibrils. Advanced alterations with breaking down 
of the chromatic substance are thus seen to be in no way 
dependent upon destructive disturbances of the fibrils, nor to 
determine the latter, since the two histological elements 
stand in no demonstrable relationship to each other. 

Jansky's findings are not in harmony with those of 
Dagonet (La persistance des neurofibrilles dans la paralysie 
generale, Comp. rend, de la Soc. de Biol., Vol. 57, 1904.) 
He examined the brains of three patients who had died of 
general paralysis, using the Ramon y Cajal method. Por- 
tions of the cortex taken were from different regions 
(parietal lobe, central and third frontal convolutions, ante- 
rior portion of the third frontal lobe, occipital lobe, cere- 
bellum, vermis, oblongata, and cord.) The extracellular 
fibrils were found to be universally preserved in all portions, 
including those in which the brain substance presented 
marked changes, the fibrils being normal in character. The 
intracellular or secondary fibrils could also be plainly seen 
and demonstrated. In the most marked atrophic cells the 
fibrils formed undulating bundles around granular masses. 
There was no granulation or pigmentation of the fibrils. 
The fibrils of the Purkinje cells and cord cells were equally 
well preserved. 



Neurones in the Light of Our Present Knowledge. 



61 



On the other hand, Marchand (Lesions des Neuro- 
fibrilles des cellules pyramidales dans quelques maladies 
mentales, Comp. Rend, de la Soc. de Biol., Vol. 57, 1904) 
has found very distinct alterations. The neurofibrils were 
examined according to the Ramon y Cajal method, in the 
pyramidal cells in the left ascending frontal convolution, 
central portion, and also of the second left frontal convolu- 
tion, central portion, in the following diseases: Paralytic 
dementia (two cases,) senile dementia, dementia praecox, 
idiocy, acute delirium, insanity, and paranoia (one case.) 

In the third case of progressive paralysis the lesions 
of the neurofibrils were most marked in the cells lying close 
to the meninges. Around the nucleus the neurofibrils were 
seen to disappear. A rather diffuse but distinct alteration 
of the fibrils around the perinuclear zone, consisting in 
atrophy of the protoplasmic processes, with disappearance 
of the fibrils, was observed in senile dementia. The lesions 
of dementia praecox were less extensive, presenting numerous 
pyramidal cells with normal fibrils side by side with cells 
whose fibrils were partially destroyed. In idiocy and micro- 
cephalus the cells were observed to contain many fibrils, 
but were small and had few protoplasmic processes. The 
lesions of insanity and acute delirium were rather similar; 
an irregular atrophy of the primitive fibrils, beginning around 
the perinuclear zone and spreading irregularly toward the 
sides. The amount of fibrils was found to be normal in 
paranoia. 

Ballet and Laignel-Lavastine (Revue Neurologique, 1904) 
have likewise observed certain modifications of the neuro- 
fibrils in the cortical nerve cells of a patient having general 
paralysis, which were not found in the cortical cells of three 
patients who had died of pulmonary tuberculosis. The 
modifications of neurofibrils which might be expected a 
priori in general paralysis are not visible in all the cells. 
Like Marinesco, they noted the marked contrast between 
the fragmentation, granular transformation, and rarefaction 
of the fibrils of the medium and small pyramidal cells on 
the one hand, and the integrity of similar fibrils of the 
large pyramidal cells on the other hand. In most of the 



62 



Joseph Collins— Edwin G. Zabriskie. 



small and medium pyramidal cells the more or less clear 
perinuclear region is devoid of fibrils. At the base of the 
prolongations the fibrils are often torn asunder, wavy, or 
reduced to black points — some of which seem to be rods 
as the microscope is being adjusted. These configurations 
are found in a few large pyramidal cells also. Generally, 
however, only a rarefaction of the fibrils in the vicinity of 
the nucleus is visible. 

Finally, it was demonstrated that in control brains the 
fibrillary network surrounding each cell is much richer and 
denser than in the brain of a general paralytic. From this 
point of view it is necessary to guard against error by 
comparing sections of exactly the same tint only, since 
silver impregnation increases in intensity as fields lying 
closer to the margins are examined. 

Marinesco (Lesions of the neurofibrils in certain patho- 
logical conditions, Comp. Rend, de la Soc. de Biol., 1905) 
believes the majority of those pathological conditions in 
which the chromatophil substance of the ganglion cells is 
markedly altered, likewise present corresponding lesions of 
the neurofibrils. The author was able to demonstrate such 
lesions in acute myelitis, purulent meningitis, foci of soft- 
ening and atrophic convolutions; the neurofibrils showing 
variations differing in degree, imperfect staining capacity, 
diminution in size, complete atrophy, granular degeneration, 
or thickening and disintegration. In hemiplegia and para- 
plegia the pyramidal cells present secondary changes analo- 
gous to those following division of the axis-cylinder in 
peripheral nerves. Where the disease runs a rapid course, 
the neurofibrils likewise undergo rapid alteration. The 
primary seat of the lesion is also of importance, the neuro- 
fibrils rapidly degenerating and entirely disappearing in 
subcortical lesions and in lesions of the internal capsule. 
The first neurofibrils to be involved are those in the vicinity 
of the nucleus; the neurofibrils of the processes following 
in grave lesions only. 

Parhon and Papinian (Note sur ^alteration des neuro* 
fibrilles, etc., Comp. Rend, de la Soc. de Biol., 1905.) The 



Neurones in the Light of Our Present Knowledge. 63 

neurofibrils of the ganglion cells of the brain were found 
to be more or less altered in patients having pellagra with 
marked cerebrospinal symptoms. As a rule the neurofibrils 
of the small ganglion cells presented slight changes only, 
while they were almost entirely absent in large cells, such 
as the pyramidal cells. The nucleus also was markedly 
altered in the large pyramidal cells. The cervical portion 
of the cord was more seriously affected than the lower 
portions, and the root cells worse than the cells of the 
columns. The anterior horn cells were most deeply involved, 
presenting alterations resembling those of the pyramidal 
cells in the zone of Rolando. 

Gentes et Bellot (Alterations des neurofibrilles des 
cellules pyramidales de 1'ecorce cerebrals dans l'hemiplegie, 
Comb. Rend, de la Soc. de Biol., 1905) state that in cases 
of hemiplegia, where the pyramidal tract has been destroyed 
by the hemorrhage, a number of normal pyramidal cells 
are found side by side with cells whose fibrils are dimin- 
ished in number, thickened, fragmented at the periphery, or 
entirely destroyed, especially in the central portion of the 
cell. No alteration was observed in a case where there 
was only a compression of the pyramidal tract. 

Wimmer (Investigations concerning the neurofibrils in 
the cerebral cortex in pathological conditions, Hospital- 
slidende, No. 30, 1905) examined cases of general paralysis, 
delirum tremens, senile dementia, idiocy, and also one case 
of chronic trional intoxication by means of the Ramon y 
Cajal method, with Bokay's modification. In all these 
cases he observed a more or less marked degeneration of 
the fibrils in the pyramidal cells, especially in the small 
and medium-sized cells. A form of degeneration character- 
istic of each individual disease could not be demonstrated. 

Bielchowsky and Brodmann (Journal of Psychology and 
Neurology, V, 1905, p. 173), in discussing the changes in the 
fibrils in pathological conditions, say that the scanty histo- 
pathological examinations chiefly consider the qualitative 
alterations in individual cells only. These procedures, how- 
ever, are capable also of furnishing reliable data for the 



64 



Joseph Collins — Edwin G. Zabriskie. 



quantitative defects caused by pathological processes, and 
moreover they afford a view of the nervous fiber belt situ- 
ated between the cells. The author's findings were ob- 
tained exclusively by means of the Bielchowsky method. 
For the purpose of obtaining control specimens they began 
by examining definite areas of three normal brains, fol- 
lowed by the examination of exactly the same convolutions 
in seven pathological cases of an absolutely typical clinical 
course (dementia paralytica, dementia senilis, and idiocy). 
The results of their observations are proof positive of the 
reliability of the Bielchowsky method, the authors attach- 
ing special importance to the following points: 

1. With reference to the normal histology of the cer- 
ebral cortex, the silver image is capable of completing and 
improving the customary parenchyma methods in various 
ways. The entire cortical structure appears much better 
differentiated in regard to the formation of fibers as well 
as of cells, (a) The nervous fiber-felt is much denser in 
the outer cortical layers, notably the first, second, and 
third layers, than in the medullary sheath specimen. Be- 
sides the medullated fibers, exceedingly numerous nonmed- 
uliated elements, especially in ramifying protoplasmic pro- 
cesses of the ganglion cells, participate in its formation. 
(b) The shape of the cells is very manifold, on account of 
the large number and great extent of the dendrites which 
are represented. The Bielchowsky method permits the dif- 
ferentiation of new types of cells, and based upon this, a 
finer differentiation of the layers in various segments of the 
convolutions, (c) The fibrillary structure of the cells per- 
mits the division of cell types hitherto considered as homol- 
ogous, for instance, various forms of giant pyramidal cells. 
(d) The last-named properties result in greater varia- 
bility of the cortical arrangement in general within individ- 
ual layers as well as entire cortical areas. 

2. For the pathological histology of organic psychoses, 
the fibril preparation furnishes results applicable in the uni- 
form valuation of all nervous components. Pathognomonic 
characteristics of individual elements of the cortical paren- 
chyma cannot be recognized in the fibrillary picture. 



Neurones in the Light of Our Present Knowledge. 65 

(a) As the principal characteristic of progressive pa- 
ralysis, the parenchyma presents remarkably profound 
alterations in all the cells even to the disappearance of 
entire cellular layers with relatively fair preservation of the 
fibrous constituents. This circumstance is important for the 
functional valuation of the cell, the significance of which 
has of late been underrated. 

The cell of general paresis is generally characterized 
by the early and extensive destruction of the processes and 
by the resolution of the fibrils, with temporary persistence 
of individual fibers in the body of the cell. The fibrous 
felt is markedly thinned out, especially in the finest ele- 
ments. 

(b) In senile dementia, in contradistinction to general 
paralysis, the outer shape of the cell with its dendrites is 
well preserved, as are likewise the cortical layers. The 
cellular structure is characterized by enlargement and 
bunching of the fibrils. The intercellular loss of fibers is 
less pronounced and affects coarser and finer constituents 
more uniformly than in general paralysis. 

(c) In idiocy the shrunken convolutions presented rad- 
cally different findings. The arrangement of the layers, 
the forms of the cells and the fibrillary structure were 
quite atypical. The number of fibers and cells was notably 
decreased. 

Studies of the fibril changes in peripheral nerves after 
resection and during regeneration has produced two groups 
of observers who combat each others' views almost as 
bitterly as the opponents and defenders of the continuity 
theory. Waller established his law of regeneration a long 
time ago. But even in the early eighties Vulpian and 
Phillippeaux claimed to have seen axis-cylinders developing 
in the peripheral ends of severed nerves where they con- 
sidered there was absolutely no chance of communication 
between the central and peripheral stumps. Since then 
their observations have been corroborated by Modena, Bethe, 
Howell -Huber, Marinesco, Van Gehuchten and others. These 
latter, by means of the various silver methods have found 



66 



Joseph Collins — Edwin G. Zabriskie. 



innumerable fine nerve fibrils in the peripheral stumps 
where there was no chance of communication with the 
central portion. These fibrils develop from the protoplasmic 
bands which arise from the cells of the sheath of Schwann, 
and can be seen as delicate fibrils lying in these bands. 
This view has been further supported by the embryological 
studies of Bethe and Schaffer who claim that the axones 
of peripheral nerves are not outgrowths of the anterior horn 
cells but develop independently with the bands of cells from 
the neural ledge which ultimately forms Schwann's sheath. 
Unfortunately for this view however their claims have been 
completely upset by the recent brilliant experiments of 
Harrison, to which we will refer later on. 

This manner of regeneration has been termed auto- 
genous and has become very popular with the rank and 




Fig. 7. — Psotoplasmic band containing tous nuclei, and in the 
interior can be seen fibres crossing or fusing at different points of their 
course. After Marinesco. 

file of neurologists. A certain number of investigators, 
including Stroebe Vanlair, Lugaro and Cajal vigorously deny 
this manner of regeneration. Their studies have demon- 
strated the central outgrowth of the fibres through the 
intermediary connected tissue into the peripheral stump and 
then on to their terminals. The fusiform cells and proto- 
plasmic bands in whose vicinity the newly formed fibres 
are found to perform either nutritive functions or else are 
endowed with certain phagocytic properties for the absorp- 
tion of the broken down sheaths and fibres. Cajal has 
ascribed to them certain properties which he calls chemio- 
tactic in that they have the power to attract the outgrowing 
fibrils in their direction. 

Marinesco (Journal f. Psychologie u. Neurologie, Bd. 
VIII, Heft 3-4, 1906) after further researches has recently 
been obliged to completely modify his views on this subject. 
He finds he can no longer support the claims of Bethe, 
et al. Use of the Cajal method has convinced him that 



Neurones in the Light of Our Present Knowledge. 67 

while there are many terminal masses and globules in the 
central stump there is always a large number of fine fibrils, 
a veritable plexus which pushes swiftly through the inter- 
mediary mass of tissue into the peripheral portion of the 
nerve. He contends that serial sections show diminished 
activity in the process, the further away we get from the 
central portion, (a fact also observed by Eethe,) and that 
there are always fibrils in the intermediary tissue between 
the two stumps. In concluding, however, he rather spoils 
his own cause by citing certain cases where after tearing 
out the central portion, fibrils could be demonstrated in the 
peripheral stump despite very decided atrophy of the cor- 
responding anterior horn cells. 

Our own observations have led us to conclude that one 
should be very cautious in accepting the various descrip- 
tions of alteration in the neurofibrils. That alterations do 
exist in pathologic states is probable enough to be almost 
certain, and it is only against the tendency to accept too 
readily the attempts to classify them that we advise. This 
seems specially true of the Cajal method, depending as it 
does upon the well-known, rather uncertain, powers of pen- 
etration which silver salts possess. In the most successful 
preparations by this method there are always two zones, 
where the staining is absolutely unsuccessful; even in the 
middle zone, where the stain is most successful, all the 
cells are not impregnated regularly and evenly, and we 
have found not infrequently badly stained cells in normal 
preparations which resemble quite closely some of those 
described as pathologically altered. 

Marinesco has given elaborate descriptions of the changes 
in the neurofibrils after tearing out the hypoglossus of rabbits. 
His records show changes from the forty-eighth hour up to 
thirty days, whereas our own preparations of the hypoglossa 
nucleus fail to show even at the end of the fifth day the 
changes he describes as having already taken place at the 
end of the thirty- sixth hour. We can corroborate his obser- 
vation that only the anterior external group is affected, but 
the only alteration in the fibrils themselves seems to lie in 



68 



Joseph Collins— Edwin G. Zabriskie. 



a paler and more delicate stain. They no longer possess 
the dark, sharply differentiated outlines of the neighboring: 
cells, and the contrast is quite marked. We are unable to 
see that granulation and loss of structure, he so graphi- 
cally describes, or a tendency of the fibrils to arrange 
themselves in bundles. 

The Bielchowsky method, on the other hand, is much 
more logical in that it gives us a more constant stain of all 
the elements in the section, and the modifications have 
rendered it simple enough to permit most workers to become 
conversant with and rely on it. But here also there is need 
of much corroboration before the evidence can be accepted 
as final. 

The new teachings ask us to imagine a fiber without 
a cell— a thing which we cannot do unless we give up the 
cellular theory. 

Although there seems to be a necessity to modify the 
neuron theory, nothing has yet been done to cause it to be 
abandoned. In fact, some of the later work of Cajal, carried 
out according to his new method of staining, has strength- 
ened the position of those who adhere to the neuron theory. 
For instance, Cajal and Retzius have both demonstrated 
the existence of a neurofibrillary network in the ganglion 
cells of vertebrates. Cajal maintains that these neurofibrils 
remain in the ganglion cells and their processes; they do 
not leave it as claimed by Apathy and Bethe, they do not 
emerge freely, they do not form connections with each other 
and accordingly they do not form a true network in the 
dotted substance, but merely an intimate interlacing. Cajal, 
Retzius and other investigators maintain that the neuro- 
fibrils in invertebrates belong to the cellular structure of 
the ganglion cells and their processes, being formed within 
them in situ instead of having migrated into them from 
without as described by Apathy and Bethe. If this is so, 
and at the present time it must be accepted, it tends 
materially to strengthen the neuron theory, for no proof 
has been furnished, apart from their mere existence of their 
extracellular appearance, and their seeming endlessness. 



Neurones in the Light of Our Present Knowledge. 69 

That the neurofibrils are the actual and only conducting 
element of the nervous system has been assumed, but the 
assumption is based upon the correctness of the evidence 
furnished by Apathy, Bethe, et al., and has been contra- 
dicted from most reliable sources. 

Even though it is granted for the sake of argument 
that there is an intercommunication of the neurofibrils 
belonging to the motor and sensory system by means of 
networks in the cell -body, this is not adequate ground for 
asking us to abandon the neuron theory. There is no proof 
whatsoever that the fibrils have the function of conducting. 
That is an assumption just as the existence of a fibrillary 
acid by Bethe as the condition of nervous conduction is an 
assumption. 

On the other hand, the neuron theory does not get all 
its support from histological study of vertebrates or inver- 
tebrates, by any means. As we shall point out later, it 
receives some of its strongest corroboration from embryology. 
But even though it were so dependent there would still be 
much histological evidence in support of it. For instance, 
the relation of the collaterals in the spinal cord, the free 
terminations of which can readily be demonstrated, the 
relation of the end-baskets around the Purkinje cells, and 
the granular cells of the cerebellum which Michotte (Le 
N^vraxe, Vol. VI., No. 3) has particularly studied, many 
of which we have previously mentioned, and the results 
of study of the retina. Cajal has been able to demonstrate 
in the retina fibrillary network within the cell-body, also 
the anastomosis formation of the fibrils within the dendrites, 
but he was not able to see the anastomosis between two 
ganglion cells which Dogiel and Graef described. 

One of the strongest supports of the neuron theory 
has been the teachings of embryology as set forth by His 
and his school. Those who oppose this theory look upon 
peripheral nerve fibers as the product of innumerable cells 
arranged one after another in chains which remain in fully 
developed nerves in the shape of Schwann's cells (Dorn, 
Apathy, Bethe, Schultze.) But a recent work of R. G. 



70 



Joseph Collins — Edwin G. Zabriskie. 



Harrison of Baltimore (Sitzunsber. der Niederrhein. Ges. f. 
Natur. Heilk. z u Bonn, 1904,} which has been received 
most favorably by embryologists and anatomists, gives the 
most unequivocal support to His' teachings that every nerve 
fiber is the outgrowth of an individual ganglion cell. Harrison 
shows, from many observations on the larvae of amphibia, 
that Schwann's cells, like the spinal ganglion cells, are of 
ectodermal origin and come from the so-called ganglion 
ledge of the neural canal. When this ganglion ledge is 
removed from the body at a certain stage of embryonal 
development and then the nerves develop in the normal 
way, it gives incontestable evidence that Schwann's cells 
as well as their cells of origin have no participation or 
significance in the formation of axis-cylinders. In other 
words, the peripheral spinal nerves may develop when the 
sheath-cells are entirely absent. This idea Harrison believes 
is substantiated by the fact that after complete extirpation 
of the ganglion ledge he has observed the development of 
naked fibers in the periphery. 

His conclusions are: The axis-cylinders of motor nerves 
develop in a normal way in embryo frogs in "which the 
development of Schwann's cells are prevented by cutting 
out early the ganglion ledge. The nerve consists in these 
cases of naked fibers which may be followed as such to 
the ventral portion of the thigh and tail muscles. 

The sensory nerves of the tail in Triton larvae, naked 
ramifying fibers, which, from their origin in the posterior 
cells, and the cells of the spinal ganglia to their ending, 
show no Schwann's cells. The latter are to be seen for 
the first time only after fibers have formed; they proceed 
gradually from the center toward the periphery, as is evident 
from a comparison of different stages, and also from direct 
observation of the fins of living frog-larvae. 

The Rohon-Beard's posterior cells of the frog embryo 
consist of early protoplasmic formations, which gradually 
stretch themselves under the skin to nerve fibers. The 
termination of nerve fibers so constituted consists of a 
thickening with fine pseudo podii prolongations. The nerve 



Neurones in the Light of Our Present Knowledge. 71 

fibers are first of all simple, later they intertwine and 
eventually through interlacing with neighboring cells con- 
stitute a plexus. From the beginning to the end there 
are no Schwann's cells in these nerves. From which it 
appears that nerve fibers come exclusively from nerve cells. 

Carrying the experiments a step further, Harrison excised 
in young embryo of Rana sylvatica and Rana palustra the 
ventral portion of the neural tubes from the cells of which 
develop the neuraxons of the spinal motor nerves. He left 
the neural ledge from which develop the spinal ganglia 
and sheath -cells intact. The result was that the latter 
developed normally, but of the former not a trace. Thus 
he proved incontestably, and in a way reflecting the greatest 
credit upon his insight and ingenuity, that the motor 
neuraxons are processes of the anterior horn-cells, and that 
the sheath-cells cannot by themselves originate these fibers. 

The one thing that is needed by the opponents of the 
neuron theory is to show the transition of a sensory, cen- 
tripetal impulse, to a motor centrifugal tract without the 
intermediation of a ganglion cell. If they could do that 
their claims would be established. Whether they first go 
in or come out of the cell, whether the elementary trellis 
formation is originally extracellular or intracellular, whether 
the fibrils are at all interrupted at Ranvier's nodes, or 
whether there is a free peripheral termination, are all 
matters of trivial importance compared with this, for then 
the neuron theory would lose its applicability and useful- 
ness to the problems of physiology and histology. 

37 West 54th St. 



ALCOHOL IN THERAPEUTICS. 



By C. H. HUGHES, M. D. 

St. Louis. 

THIS important subject received much and significant 
attention at the late dinner of the Dominion Alliance 
against Alcohol of the British Medical Association, Mr. 
Victor Horsley delivering one of the principal addresses. 
Our friends, Murdock Cameron, of Glasgow, and Henry O. 
Marcy, of Boston, also Professor Woodhead of England, be- 
ing equally forceful in their presentation of the indictment 
against alcohol as a beverage and too common therapeutic 
agent. 

Sir Victor Horsley took very strong ground in favor 
of lessening the use of alcohol in connection with surgical 
operations, and Professor Woodhead, of Cambridge Univer- 
sity, was equally pronounced in his opinion that good would 
result from using less alcohol in the practice of medicine. 

They assert that a great change has passed over both 
branches of the medical profession toward alcohol as a 
drug. Horsley stated that when he was a student it was 
the custom to give alcohol freely to each patient before the 
performance of an operation. Since the discovery by Lord 
Lister of the principles of antiseptic surgery this custom 
has largely died out, and a year ago a well-known practi- 
tioner said he had not used alcohol in seven years in gen- 
eral practice. It was formerly the custom to give patients 
alcohol also after operations, but its place has been taken 
by other drugs better adapted to serve the purpose in view. 
Professor Woodhead's testimony was equally emphatic and 
satisfactory as to the progress made in the same direction 
by British medical practitioners. Men who formerly looked 
upon alcohol as necessary in the treatment of various diseases 

(72) 



Alcohol in Therapeutics. 



73 



are now satisfied that it produces an injurious effect on the 
patient's power to resist disease. Men who have made 
laboratory investigations regarding the actual value of alco- 
hol as a medicine have generally come definitely to the 
conclusion that its use tends to lessen rather than increase 
resistance to disease. 

Dr. Marcy, of Boston, whose experience dates back to 
the time when he was an army surgeon during the civil 
war, and Dr. Murdock Cameron, of Glasgow, added 
the information that hot water or milk and soda had 
been used with advantage, instead of the alcohol formerly 
given so freely to patients about to undergo surgical opera- 
tions. By hospital statistics Sir Victor Horsley showed 
that in seven great London hospitals the annual expendi- 
ture on alcohol had decreased in forty years from forty 
thousand to fifteen thousand dollars, while the annual ex- 
penditure on milk had in the same interval increased from 
fifteen thousand to forty thousand. He showed also that 
during twenty-five years in the Royal Infirmary at Salis- 
bury the annual expenditure on alcohol had fallen off from 
fifteen hundred dollars to thirty-five dollars. 

If alcohol is harmful as a drug in general, it is worth- 
less as a drink. The marked and sometimes fatal affinity 
that alcohol has for the water of the tissues and cerebro- 
spinal and interventricular fluids and the fluid bathing the 
nerves and neurones, ought to suggest the the danger of its 
extensive use, even when largely diluted in readily eliminatable 
form, as in beer and wine and highballs, though when well 
chaperoned on its way through the system to the emuncto- 
ries with large quantities of water, its harmfulnes of courses, 
is thereby diminished. 

Yet it is always a menace to organic integrity and 
vasomotor stability, in therapeutics and should be pre- 
scribed sparingly and cautiously with these facts in view; 
under the wisest of skilled physiological precautions, in 
hands of utmost therapeutic wisdom, and while alcohol in- 
creases thirst and promotes elimination when largely di- 
luted, as in ale and beer, or with plenty of water, it 



74 



Charles H. Hughes. 



nevertheless clings tenaciously to the organism and only 
the largest quantities of water can dislodge it in cases of 
transient alcoholic toxhemia. This fact should always be 
considered in administering it therapeutically and especially 
when contemplating its use as a beverage. This fact gener- 
ally contraindicates. its prescription. It tends to parch 
the tissues and impair tissue and viscera functions. 

Regarding alcohol in any form as an habitual beverage, 
wisdom dictates abstention from its use as an exhilarant, 
in the light of the now well-known perverted physiology 
and pathological anatomy resulting from its use. It is 
in the main a patho- physiological and anatomical mocker, 
as it was long ago wisely pronounced before the discovery 
of its vasomotor paralytic powers, its arteriole, hepatic and 
other viscera and tissue destructive influence. 

The mentally and morally degenerating influence of habit- 
ual excessive alcoholic indulgence, though now a matter of 
common observation, has also long been well known to the 
medical profession since the researches of Morel called special 
attention through close observation of alcoholized individuals 
and their descendants, to the vicious evolution therefrom 
and therein of the neuropathic diathesis and its destructive 
train of fatal results to posterity, through which so many of 
the epilpsias, imbecilities, idiocies, and insanities are en- 
gendered. 

We now know too sadly and too well through confirm- 
atory observation, of the psychic neurone depressing power of 
persistent and excessive alcoholism, to look lightly upon 
the careless use of this potently harmful nerve center 
poison. The alcoholic multiple neuritides, affecting the peri- 
pheral nervous system, through morbid changes, also at their 
centers, added to our knowledge of the alterations of the 
psychic and psychic-motor neurones and the changed 
quality of the ventricular fluids under its prolonged use, 
admonish us to caution. Its potent influences too in coun- 
teracting the poison of the crotulus on the central nervous 
system is significant of its sometime therapeutic power.* 



*The neuritides of alcohol are probably due to its power of abstracting the 
fluid surrounding the axis cylinder beneath and nourishing the neurilemma. 



Alcohol in Therapeutics. 



75 



The insidious hold that alcohol takes of the psychic 
neurones and all the pathologic changes demonstrated by 
Bevan Lewis and his co-workers, predecessors and followers, 
carry an especial caution to scientific observers and thinkers 
in the domain of practical medicine, causing them to beware 
how alcohol's fatal potency for harm to the organism may be 
established through its fatal instrumentality, as that of opium, 
has been, largely through indiscreet, careless, incautious, 
indiscriminate prescribing, especially by druggists, and the reck- 
less, thoughtless or venal refilling: of prescriptions by crafty 
pharmacists, etc. The unfortunately and often fatally endowed 
man and woman with the inborn or morbidly acquired aptitude 
to fatal alcoholic excess is always with us, and, as it would 
be harmful to ask such a one to take even a sip of wine, 
as is often done at social parties and at the family table, 
it is imperative upon us to be especially cautious in such 
cases as to the giving of alcoholic medication in our prescript- 
ions. 

Several thousands of years have elapsed since it was 
said by the wise man of holy writ, "Woe unto him that 
putteth the bottle to his neighbor's lips," yet the treating 
habit continues, the insidious beer canning, making 
incipient inebriates, is growing, light wines are considered 
harmless habitual beverages, to be taken at meals ad libitum. 
We prescribe the alcoholics verbally and undisguised, our 
banquets are now much more moderate in the serving of 
alcoholics, yet continue to serve alcoholic drinks first and 
coffee last; whereas the rational way would be to first 
offer the exhilaration of coffee and tea and offer, if they 
offer them at all, the alcoholics last. The better way would 
be to omit the alcohols altogether or serve them on a side- 
board or from the bar to those whose already formed habits 
are such that their psychic neurones can not be brought 
into convivial action without the coursing of the poison 
through their circulation to toxically arouse the otherwise 
dormant brain activity. Set them only for those who, by 
force of long alcoholic imbibing habit must have the 
toxic scourge, or think they must, to bring their psychic neu- 
rones into vivacious action. 



76 



Charles H. Hughes. 



It was not "Luke the good physician" who in the earlier 
Christian days prescribed "a little wine for the stomach's 
sake" of ^Timothy, but Paul who himself often needed a 
physician. St. Paul in the cerebrasthenic periods of his 
glorious but often over-strenuous life, probably found in the 
wine of his day, much of it unfermented, a grateful relief 
to his cerebrally dyspeptic stomach and a restful diversion 
from his over-anxiousthought and duty well-done toward God 
and man. But, like the cruel crucifiers of his Master, he knew, 
not what he did to posterity through that brief, uninspired 
therapeutically wrong admonition to his suffering colleague in 
Christian work, although the advice sprung from a natural and 
very common human impulse to help heal an afflicted associate 
by remedial suggestion. This advice to Timothy, his brother 
.in Christ, has been quoted and acted upon millions of times, 
both by the saintly and the ungodly, to the harm of man- 
kind, regardless and ignorant of the inherent oinopathic 
proclivities of many with whom the alcoholic road once 
taken, even for relief of disease, and sometimes at the com- 
munion, is never forsaken. It is not long since a man 
of New York, clad in the holy vestments of his sacred 
office, more thoughtless and less pious probably than Paul 
of Corinth, but a counsellor in the name of the blessed 
Christ, invoked in His holy name the blessing of God on 
moderate daily alcoholic beverage drinking, the end whereof 
is usually moral as well as physical and mental degradation, 
degeneration and ruin through ultimate demonstrable damage 
of brain and other organic tissues and viscera. 

The medical profession in times past has done its share 
in this form of unwise counsel along with the clergy and 
the rest of mankind. Let it do no more of it, but admonish 

*It does not appear in biblical record that Timothy was an oinopath or that 
he ever became a dipsomaniac in consequence of St. Paul's advice. He was not so 
fatefully endowed in his cerebro-psychic centers, nor was Paul. But what if either 
had been. Many a gifted Divine has gone the road to ruin from following Paul's 
advice to Timothy and that other biblical encomium on wine that "it maketh 
the heart glad." Wine indulged in as a daily beverage has saddened the hearts of 
millions and maddened the minds of men since this fatal encomium was uttered. 
Paul's consent to the stoning of the protomartyr Stephen, which through remorse 
contributed to bring about his own atoning conversion, could have worked no 
greater ,harm to mankind than that consented to but repented act of the good 
apostle. 



Alcohol in Therapeutics. 



77 



and practice in the light of later observation and scientific 
teaching concerning alcohol used as a beverage. The 
oinopathic diathesis confronts us as never before and the 
latent drink-crave stricken, needs from us as much consid- 
eration as we would give the ''pestilence that walketh in 
darkness" to destroy. 

Bacchus will reign the supreme monarch over the lives 
of many men long after we shall have gone from earth, 
but let us not promote the perpetuation of his power over 
the human brain and mind by friendly aid and counsel 
against our knowledge and conviction, revealed to us by 
experience and the unerring teachings of science, as to 
alcohol's morbid destroying marks made on the human anatomy. 

We are bound to consider the unfortunate psycho- 
path, to whom alcohol in quantities which would 
not markedly impress another, acts as an immediate poison 
to the brain, developing the instability of delirium and even 
of marked insanity. He astonishes his friends who are 
imbibing with him by becoming crazy drunk within a few 
minutes after taking a few social glasses. This is the man 
from whom his companions wish then to get away, but often 
cannot, until some untoward denouement happens to require 
his restraint. This is the sort of oinapath in whom a little 
liquor is a dangerous thing and is diagnostic of the psycho- 
pathic diathesis, causing abnormal conduct, unnatural to the 
same individual in a non-alcoholized state. 

This property of alcohol, so harmful if this vaso- motor im- 
pression and sequent arteriole dilation be excessive and too 
long continued, as in cases of habitual inebriety, making 
the once well man diseased, may come often to our aid if 
we use it aright, by compensating for the vaso-motor de- 
pression by substantial chemico-nurrient support, and by 
chaperoning it well on its way through the circulation by 
an ample supply of water for the protection of the 
tissues, without the patients having knowledge of or discre- 
tion in, the dosage or repetition of the prescription. 

Conditions of blood stasis, atheromatous vascular con- 
tractures and many other states of vessel and blood de- 
mand its therapeutic employment, because of its undoubted 



78 



Charles H. Hughes. 



physiopathologial vaso-dilation at times, its power of arteriole 
relaxation, as well as in certain states of toxhaemia (often 
autotoxic) heart depression, that suggest its opportune and 
helpful use to the physician. We should so employ it al- 
ways, however, in such manner as will prevent secondary 
alcoholic disease developing, as we employ other toxic 
agents, the cautious employment of opium or its salts, for 
example. 

Rightly given it may do good then as a medicine, but 
it is always bad as a beverage. Bad if used by the pa- 
tient at his discretion and taken ad libitum. Only a judi- 
cious physician, conscientiously and with right information, 
alert and alive regarding its ultimate dangers, as a possibly 
pathic and fatal habit developer, should prescribe and 
regulate its use. 

It should have place in the medical mind only as a 
medicine, toxic to the organism like many other medicines 
when given in quantities and at intervals beyond legiti- 
mate therapeutic indications. 

The fear of alcohol as a beverage is the beginning, and 
the abstention therefrom by the oinopath, the psychopath 
and the doctor who prescribes for them, the conclusion 
of wisdom. 

The vasodilator value of the alcoholics must be con- 
sidered just as carefully as we regard the vasoconstrictor 
influence of the bromide salts over the arterioles in thera- 
peutic problems. These properties make both exceedingly 
valuable in certain features of medical practice not enough 
considered, as we may glean from therapeutic recommenda- 
tions of treatment from the present-day literature, though 
we must regard the danger of the drink habit in giving 
alcohol and the inherent neuropathic aptitude, while the 
drug habit of bromide prescriptions is nil, or at most, in- 
significant. Bromides may be cut off at any time without 
inconvenience to the user, while alcoholics usually can not, 
if the patient be well of his malady and it has been long 
employed. 

One exceedingly valuable as well as harmful transient 
use of alcohol, is in its employment for overcoming sudden 



Alcohol in Therapeutics. 



79 



heart failure, syncope and impaired or lost consciousness. 
If the pulse is perceptible it is better to let the prone po- 
sition restore to consciousness, with but little alcoholic 
stimulation nicely adjusted in dosage to the accomplish- 
ment of gradual restoration without undue vasomotor dila- 
tion, giving the shocked and damaged cerebral neurones and 
vasomotor centers a chance at physiological recuperation 
without undue cerebral congestion, especially if the cause 
be a blow upon the head, which may have caused an or- 
ganic cerebral traumatism. But the frequent practice of 
young, inexperienced physicians not specially skilled in 
traumatic brain diseases or rightly regardful of the vasomotor 
paralyzing and brain-flushing power of alcoholic liquors, is 
to give those stimulants while the man is down, too liber- 
ally in quantity and repetition for the after good of the 
brain. And the first thing that suggests itself to the know- 
ing bystander, who may have a bottle or be accustomed to 
daily alcoholic drinking, is to too liberally give the pros- 
trate victim of head violence too much whiskey or other 
alcoholics, to the impediment or aggravation of brain con- 
gestion or inflammation after the reaction sets in. 

We may put many bad agencies and things to good 
use, and so may we do in prescribing the alcoholics, but 
they should be handled, as we may discover from even 
this incomplete survey of its powers, with a clear insight 
as to their therapeutic, toxic and ultimate brain-enthralling 
and disease-engendering potentialities and possibilities, 
even in prescription form or form of patent medicine. 

Indeed, the insidious peril of the alcoholized patent or 
popularly used proprietary medicine is among the greatest 
of alcohol's dangers. They clandestinely destroy the victim be- 
fore he is aware of his thraldom, if he pitifully be among 
that unfortunate class who, by reason of inherent neuro- 
pathic infirmity, which too often blindly seeks surcease of 
neurotic irritability and neurasthenia in these disguised al- 
coholics. Unlike one ofthe most venomous of serpents, 
to which a great man has compared the worm of the still 
and its product, they give no warning of their concealed, en- 



80 



Charles H. Hughes. 



thralling, fatal poison to the neurone unstables and non-resist- 
ing who, once well started in alcohol-taking, can never turn 
back. I mean the dipsopath, the oinopath, the dipso- 
maniac. 

In fact, the aim of all treatment, where narcotics or 
stimulants of any sort are employed, should be to con- 
serve the integrity of the central neurones, especially the 
psychic, after the conclusion of the treatment and the re- 
covery of the patient. This is important in the manage- 
ment of chronic alcoholism and acute periodic inebriety, 
wherein the so-called Keely method, popularized though not 
originally devised by that surgeon, finally fails, because the 
neurological knowledge which dismisses a chronic alcoholic 
after six weeks more or less of brief treatment, is insuffi- 
cient for the right remedy of the neuropathic antecedents 
and sequences of chronic alcoholic toxhemia, etc. 

In conclusion, let me not be understood as dis- 
countenancing the prescription of alcoholic preparations 
or combinations in minimum dose for therapeutic indica- 
tion in all proper cases, and always well diluted, to mini- 
mize incident alcoholic tissue damage, as in diabetes, melan- 
cholia and some fevers but in concealed prescription form. 

My plea is for physiological and psychological discretion 
and discrimination in its use, as to dosage, method of pre- 
scription and the discountenancing of the erroneous unsan- 
itary beverage idea for the sick, and for the prevention of 
the alcoholic beverage danger to the well, that may come to 
certain, and many persons from its needlessly prolonged and 
voluntary use, especially during and after convalescence. 



RECURRENT FUNCTIONAL AS DISTINGUISHED 
FROM THE TYPICAL ORGANIC DEMENTIA 
SENILIS OF THE LITERATURE. 



BY C. H. HUGHES, M. D. 

ST. LOUIS. 



DEMENTIA of the aged has come down to us from the 
fathers in psychiatry as generally regarded as an 
organic, chronic and incurable condition of cerebral and 
coincident psychic decadence, and described as caused by 
the invariable arterial, arteriole, or brain cell, atrophic changes 
of senile decay or as the sequence of other organic brain 
disease. 

Dementia senilis has been mostly described to us as 
it appears in most chronic forms within hospitals for the 
insane. The autopsic findings of pure senile dementia as 
described in the literature have not always been differen- 
tiated from terminal dementia in the aged, appearing as the 
result of previous (and acute) mental disease or a conse- 
quence of cerebral sclerosis or of tabes dorsalis or as due 
to the combined excesses of tobacco, alcohol or other narco- 
stimulants and as age decadence. 

But there exists beyond a doubt, for the evidence is 
convincing if we but closely watch and question our cases, 
a form of senile dementia which is merely a transient func- 

(81) 



82 



Charles H, Hughes. 



tional cerebrastheniac dementia, capable of recovery and 
recurrence, as functional and curable and as liable to recur- 
rence as dementia prascox, a term misleading, inexact and 
unmeaning, like dementia paralytica, for the paretic is not 
more demented in the earlier stages of his malady than 
the paranoiac in the earlier periods of this remarkable 
cereoro-mental malady, misnamed "dementia paranoides." 

Dementia prascox, with some others, might be decently 
interred, as the Journal of Mental Science has recently sug- 
gested, in a verbal cemetery. It is an adolescent insanity.* 

The term "dementia," in strict psychopathic language 
should designate the cerebro-mental morbid state its deri- 
vation implies — dementia — the deprivation or absence of mind, 
paralysis of mind, not the simple morbid mental perver- 
sion with mental debility or anurgia which some authors 
term "dementia." But these terms have been scientifically 
sanctified by long accepted usage of the masters and the 
savants in our ranks and we shall perhaps long continue 
to use them. 

The recognition of a condition of psychopathic neuras- 
thenia resembling organic dementia senilis is important from 
therapeutic, prognostic and medico-legal points of view in 
which the patient and his friends, his heirs and the phy- 
sicians' standing are alike interested. Because the brain 
of an aged, debilitated person collapses in involuntarily 
simulated dementia under mental stress unusual to him, we 
should not conclude that he is therefore to be permanently 
demented, even though he may have passed the three score 
and ten limit, or be yet older and regarded as extremely 
aged and old enough to die, especially by anxious waiting 
heirs. Cerebrasthenia comes to the aged as well as to the 
young and a transient or permanent impairment of memory 
and understanding and mental spontaneity of thought and 
volition may follow therefrom, simulating dementia of the 
aged and under judicious treatment this form of dementia 
may be caused to disappear. Shakespeare, in the character 

*In this connection the Journal notes on this subject in the April, 1905, Journal 
of Mental Science and Dr. McCanahey's paper on Adolescent Insanity in the same 
number will prove interesting and instructive reading on this subject and inciden- 
tally on the subject of my present paper. 



functional vs. Organic Dementia Senilis. 



83 



of King Lear, has depicted alternating normal and abnormal 
senility, as he shows in Hamlet both the insanity of neuras- 
thenia and the recuperated capacity for simulation. 

In fact neurasthenic aged persons, if they be financially 
well circumstanced and can be placed congenially from the 
standpoint of a wise psycho-therapy, conducted by right 
psycho and neurotherapeutic skill, may recover their mental 
equilibrium under treatment as readily as the passion or 
ambition or evil habit deranged young man or woman. 

More than three decades of special observation of neu- 
rasthenically demented old people, and comparing results 
with the general run of the organically demented of the 
asylums for the insane, has led to this conclusion, based 
on cases both within and without insane hospital practice. 
I have drawn my conclusions of the curability and differ- 
entiation, (from personal clinical observation in certain of my 
own cases) of functional and curable from organic incurable 
dementia in the aged, being content on this occasion to cite 
but one of my own, after noting the remarkable tabulated 
results given by T. S. Clouston, from the records of the 
Royal Edinburgh Asylum for the Insane. 

Dementia senilis has appeared to me in the trinominal 
forms — first, the progressive perverted senile neurone invo- 
lution symptomatically shown in prolonged and progressive 
psychic departure from normal mental character of the aged 
person and marked mental enfeeblement of speech, action and 
conduct of mind, "it is a progressive mental enfeeblement 
at the period of senile involution," dependent upon organic 
changes in the brain, therefore a chronic organic psychosis and 
we might well add that it is in its true typical form a pro- 
gressive chronic organic psychosis of brain decay and unre- 
mittingly exhausted brain function. The true typical organic 
dement has no marked lucid intervals, so-called, of mental 
vigor and capacity up to the normal average of the sane old 
man. Once demented always demented, when the cause of 
the dementia is solely organic psychic neurone involution. 
Not so with the functional cerebrasthenic form. 

The second form is likewise cerebrally organic to so 



84 



Charles H. Hughes. 



with the functional cerebrasthenic form, but secondary and 
dependent upon precedent organic brain disease, as upon a 
previously existing mania of brain destroying origin. We 
then call it secondary or terminal dementia. 

The third form is the one we are now discussing. It 
is a gradually and normally involuted brain plus an unac- 
customed brain stress, a transient psychasthenia or neuras- 
thenia involving the brain in weakness, not necessarily 
permanent, and causing amnesia and other symptoms of 
dementia not due to organic neurone irrecoverable decad- 
ence, but recoverable back to the normal state of the old 
person under right recuperable influences. With this differ- 
entiation between the hopeless and hopeful possibilities in 
dementia of the aged so long and so erroneously regarded 
as entirely incurable, let us now examine Clouston's record 



and results. 

Ages. Total Nos. Recovered 

60 to 65 62 24 

65 to 70 63 21 

70 to 75 40 15 

75 to 80 30 9 

80 to 85 3 1 

85 to 90 5 2 

203 72 



Clouston does not make the differentiation we here 
offer as an explanation of his recovered cases, but confesses 
that one of the most interesting and important of the results 
he obtained from an analysis of those 203 senile cases was 
a clearer idea than he had before of the course of such 
cases, their duration, and the results of treatment. The 
general result was that seventy-two of the cases, that is 
thirty -five per cent of them, were discharged from the hos- 
pital ' 'recovered ;" and sixty- nine cases, that is thirty-three 
per cent, have died; while thirty-three cases were discharged 
more or less improved, or not at all improved, leaving 
twenty-nine cases under treatment. The striking fact is 
the number of recoveries. He explains that the "recovery" 



Functional vs. Organic Dementia Senilis. 



85 



from any form of senile insanity need not necessarily be, 
and is not as a matter of fact, an absolute restoration to 
pristine vigor of mind. Some such complete recoveries there 
were, men who went out and earned their own livelihood, 
women who went out and governed their households. 

Esquirol, after citing PinePs statement in his Treatise on 
Mania, of spontaneous cure of dementia, says that what 
nature effected in the case which this celebrated teacher 
speaks of, art accomplished for a case he records of what 
would, in our day, be called dementia precox.* This 
author of the early nineteenth century, following Calmiel, 
Baiie and Guislain, conceding the curability of acute 
dementia of adolescence and mental and acute alcoholism, 
admitted only the retardation of the progress of senile 
dementia and to some extent its termination, under country 
air, moderate exercise and tonic regimen, as he saw chronic 
senile dementia in the halls of the Maison Royal des Aliens 
of Charenton. 

But acute dementia, his first variety, as he saw it, 
"resulting from temporary errors of regimen, from fever, 
hemorrhage, metastasis, the suppression of habitual evacu- 
ation or from the debilitating treatment of mania 'with' 
sudden invasion exempt from any lesion of motion" is 
easily cured by the combined agency of regimen and tonic 
treatment. t And so may the exacerbations of acute and 
transient seizures of dementia senilis, functional in form, 
as other varieties of acute dementia are curable, if the 
transient brain strain is removed and the general organism 
and the viscera are relieved and rested and restored to 
normal status of the abnormally oppressed and excessively 
anurgic burdened old person. Lighten the oppressed brain 
of the old man or woman of its needless burden of grief or 
worry, anxiety or care, and it may resume again its accus- 
tomed work, feebly as comports with the brain's age, but 
not abnormally and without dementia. 

Andrew Combe who had a clearer conception of the 
true nature of insanity than any other alienist of his day 

*Mental Maladies, Hunt's translation, 1845. 
tOpus Citat, p. 473. 



86 



Charles H. Hughes. 



said: 1 'Dementia is a form of mental affection, not in 
itself a distinct disease, but arising from a variety of path- 
ological states each requiring a corresponding treatment. 
It is characterized by general weakness of mind, involving 
all the faculties equally." 

Dementia is a morbid condition of the brain and mind, 
a symptomatic expression of disease. It may be sympto- 
matic of epilepsy or a sequel of apoplexy or fever or 
alcoholism or profound cerebrasthenia, especially in the aged. 

"Sometimes it appears from cerebral debility more than 
from the continuance of actual diseases and then recovery 
may take place. In the asylum at Milan, cases of dementia 
from inanition, and which are cured by nourishing food and 
tonics, are not rare; but, in ordinary circumstances, its 
appearance indicates incurable disturbance, or actual disor- 
ganization of the brain." 

Before neurasthenia was named he recognized the senile 
dementia that results from it, cerebral exhaustion. His 
dementia of inanition was a neurasthenic recurrable form 
of dementia caused by psychic stress and exhaustion and 
curable under rest, etc. This is the form of dementia in 
the aged of which we are writing. 

Dr. Samuel E. Smith, Medical Superintendent of the 
Eastern Indiana Hospital for the Insane, in his last report, 
1905, reflects the experience of other hospital alienists, as 
well as his and my own, in the following clinical prognostic 
observation: 

"Chronic cases are not entirely without hope and 
promise something, and they must not be abandoned to 
the darkness of complete dementia. 

"Every alienist knows something of the gratifying 
results and surprises which occasionally come from the 
management of so-called incurables, not excepting even the 
psychoses of degeneration, which are sometimes checked 
in their downward progress for a period of time, rarely 
indefinite, and it follows naturally that, as such experiences 
multiply, the tendency to narrow the incurable class grows." 

Hugh H. was a patient admitted to the Fulton, Mis- 



Functional vs. Organic Dementia Senilis. 



87 



souri Asylum for the Insane with a delusional form of acute 
mania in 1852, resulting from over brain-strain and disap- 
pointment in the mining- ventures at Galena, 111. He 
improved after years of restraint and rest of brain with 
good sleep and nutrition, as Dr. Smith the Superintendent 
informed me, during that and succeeding years up to 1861, 
and passed with age into a state which was called by my 
predecessors in the management of this institution, Drs. 
Smith and Abbot, chronic dementia. He was, however, 
after fourteen years' residence when I first saw him, 
a quiet, gentlemanly old man, having the freedom of 
the outside premises and of the neighboring city, going 
and coming each day and with regularity and punctuality, 
to meals and to his room and bed at night. He was not 
"a restless, sleepless dotard without memory, without true 
affectiveness." He was not slovenly and uncleanly in dress 
or person and showed no profound persistent general failure 
of all of his faculties as chronic dements do. 

He was neat in dress and cleanly in person and far 
from that morbid unmanageable second childhood, common 
to his class, when grave organic degeneracy has made its 
destructive dementing mark on the aged brain, though he 
was older and feebler in brain under strained endurance, 
prolonged physical exercise or the long mental efforts he 
would sometimes indulge in, when overtaxed by converse 
with his sane friends. He would then collapse, at times, 
displaying amnesia and weak delusions and imbecility of 
mind till recuperated by enforced rest and a period of 
exclusion from friends and denial of his accustomed visits 
to town for awhile. When in this state of neurasthenic 
dementia, his early delusions of running a steamboat under 
the house at night (owning the premises, etc.) and of his 
great wealth would appear. 

Under the above treatment, however, he would return 
to his normal state of senile mindedness without amnesia 
or delusions such as accorded with his age. On one of 
these occasions, after the asylum had been robbed of its 
blankets by one of the contending armies in the state, it 



88 



Charles H. Hughes. 



was decided to send all the patients, because of lack of 
maintenance funds, back to their home counties. The 
country was on fire with excitement but the Major was 
tranquil and while out again with his friends was asked if 
the management was going to send him home. To this 
he responded "y es ! The whole country has gone crazy 
and the managers wisely concluded it was useless to keep 
us few lunatics confined. We are coming out to join the 
rest of you." 

There was no insanity in this opinion for a wildfire of 
unreasoning passion was prevailing at that time throughout 
Missouri and the entire land, brother was arrayed against 
brother and son against parent or sister, wife and husband 
were not in harmony, families and neighbors were arrayed 
in deadly feud against each other and the lately best of 
friends spoke not or spoke uncivilly as they passed each 
other by. 

Senselessness of speech and conduct of dementia appeared 
at times during my daily knowledge of him for five years 
under varying brain tone states. He died of rheumatism 
and erysipelas in 1880 after I left the institution. His 
exact age was not known, though he was an old man 
with very white hair and stooped over when I first saw 
him in 1867, thirteen years before his demise. 

This communication has been lately inspired by hearing 
the testimony of a number of medical men in an important 
will case, to the effect that senile dementia was always a 
continuously and progressively hopeless loss of the faculties 
of the mind, with but one inevitable ending- in mental 
extinction, and it is to correct this unscientific error for 
which the literature of insane asylums is largely responsible* 
that this brief protest and presentation of the functional 
and curable phase of dementia senilis is presented. There 
is a true neurasthenic or cerebrasthenic dementia senilis as 
there is also in the aged a preponderance of organic senile 
decay, ending in dementia which is hopeless in its outcome. 
There are transient and curable states of senile dementia, 
in the treatment of which we should be on our guard, 
lest we consign the curable to hopelessness, and make no 
effort for their mental rescue. 



Functional vs. Organic Dementia Senilis. 



89 



To classify all aged neurasthenic functional dements as 
doomed, would be like signing an unwarranted burial cer- 
tificate in a case of profound shock from which the patient 
might rally and live. 

Mary C, past the menopause, was a patient from the 
lower walks of life whom I had classed as an incurable 
dement, she having come from among the insane pauper 
class sent by St. Louis County. When the new St. Louis 
County Insane Asylum was completed and she was taken 
to Dr. Stevens, the first superintendent of that institution, 
the transfer involving an overland trip of fifteen miles in a 
carriage, a ferry ride of several miles, a hundred- mile railway 
ride and an early autumn moonlight wagon ride, she was put 
to work in the laundry, beginning with the simplest routine 
rinsing work. She continued at work in the laundry, rising 
from grade to grade higher in occupation there, till she 
graduated through the mangle and drying room as a first 
class hand ironer and with reason restored and dismissal. 
She had done laundry work before the access of her insanity, 
which had apparently passed on to dementia. 

In conclusion let me say, this paper is written mainly 
with a view to correct a common misapprehension among 
amateur alienists especially, who without adequate clinical 
experience in the wide domain of psychiatry, conclude that 
once dementia appears in the aged it must continue to the 
finale of life. This, like the hopeless view of that psychic 
misnomer, dementia praecox. a term sanctioned even by 
Kraapelin, is a prognostic error for adolescent insanity which, 
with Brower and precedent authorities, I regard as the better 
and less misleading designation, because it is only a sus- 
pension and not a destruction of mental power and mani- 
festation, which may be and is restored under changed 
environment, altered psychic impression and further cerebro- 
psychic evolution. Under right circumstances of surroundings, 
medical management and therapeutics, neither dementia 
senilis nor dementia prascox are always incurable. They 
may both be intermittent and recoverable cerebro-psych- 
asthenia senilis of juveniles and should be treated 
accordingly and not therapeutically neglected as hopeless 
of recovery. 



THE 

ALIENIST AND NEUROLOGIST. 



VOL. XXVIII. ST. LOUIS, FEBRUARY, 1907. NO. 1. 



Subscription $5.00 per Annum in Advance. $1.25 Single Copy. 



CHAS. H. HUGHES, M. D., Editor. HENRY L. HUGHES, Manager and Publisher. 

Editorial Rooms, 3872 Washington Boul. Business Office, 3872 Washington Boul. 



Thi$ Journal is published between the first and fifteenth of February, May, August and 
November, and subscribers failing to receive the Journal by the 20th 
of the month of issue will please notify us promptly. 
Entered at the Postoffice in St. Louis as second-class mall matter. 

EDITORIAL. 

[All Uniigntd Editorials art written by the Editor.] 



THE ALIENIST AND NEUROLOGIST, entering the 
twenty- seventh year of its successful history, gives thanks 
to its many able contributors, collaborators and subscribers 
for valuable and cordial support in making it the now 
acknowledged first exponent of American psychiatry and 
neuriatry. Its aim has always been to be helpful to 
the general practitioner, as well as to the Alienist and 
Neurologist expert, and to the savant in morbid psy- 
chology and neurology. 

It acknowledges with gratitude many personal letters 
of cordial appreciation, especially during the past year, and 
promises to endeavor to continue to merit during the pres- 
ent year the good opinion of the profession interested in 
its peculiarly useful work. 

AN ILLUSTRATION OF PSYCHOKINESIA occurred 
about the close of the past year in one of our city courts, 
displayed in the firing of a revolver in the direction of the 

( 90 ) 



Editorial. 



91 



judge by one of two sister contestants in a will case, in 
which they claimed injustice in the judge's ruling ap- 
portioning a part of the property to a prenuptial but legit- 
imatized heir of the deceased, and the perpetrator and 
abettor of the uncontrollable, if not premeditated act, was 
admitted to bail. Our courts ought to learn something of 
the medico-legal aspect of these psychokinesias and im- 
perative homicidal conceptions, where explosive psycho- 
cerebral action dependent upon defective cerebropsychic in- 
hibition are liable to be repeated, like thunderbolts are to 
come from sometimes fair skies, and rule accordingly. Se- 
questration for homicidal, suicidal, pyromaniacal and other 
psychokinesias is the proper treatment, where these im- 
pulses are not rational, voluntary and purely criminal. It 
may be that these girls were overwrought by the strain of 
the trial, the reflection that an illegitimate was getting a 
share of their legitimate legacy, and perhaps a non self- 
restraint training from their childhood, which is now-a-days 
the cause of much psychokinesia, which should not be ex- 
tenuated as abnormal and exempting from penal legal con- 
sequences. Little-enlishtened, self-styled experts in 
alienism now-a-days often mistake the culmination in 
crime of lives of unrestraint for the disease form of 
psychokinesia. The latter being insanity, the former being 
the wanton wilfullness of pure cussedness, not deserving of 
the mercy demanded by morbidly engendered psycho- 
kinesia. Great criminals, committing the most heinous and 
revolting crimes, sometimes escape merited legal punish- 
ment through pseudo- insanity experts, unable to rightly 
diagnosticate insanity from gross criminality, because of ill- 
acquaintance with the clear data of true psychiatry, being 
unable to discern or exclude the disease element whose 
presence or absence alone should convict or set free for a 
home in an insane asylum. 

A pyrophile or a kleptophile, who would attempt to 
set fire to the court house or steal an attorney's pocket- 
book, would be charged with incendiarism or petit larceny, 
and have the question of pyromania or kleptomania or 
plain incendiarism or theft settled while the perpetrator 
was kept in custody. 



92 



Editorial. 



PLACEBO PHILOSOPHERS AND THE BISMARCK ARCH- 
IPELIGO EXPERIMENT appear to have proven a failure, 
one of the enthusiasts having died from inadequate raiment 
and food, exhaustion and exposure, another having been 
murdered by the savages. This colony was to have 
been a primitive, simple life paradise, inhabited by 
a coterie of German authors who were to live 4 'close 
to nature" like primeval man. They were to be a body 
of sol fraters or sun brothers, who, living and bathing 
continually in the sunlight, without clothing, on the fruits 
of the forest and the product of the sweat of their 
faces, tilled soil and tended herds. It is recorded from 
Berlin that Herren, Lutzow, Engelhardt and Battman per- 
ished of the causes above named, causing the other victims 
of this delusive Utopian dream to return in despair to civi- 
lization, convinced, no doubt, as the deluded enthusiasts of 
Topolabampo were, that it is "better to endure the ills 
we have than to fly to others we know not of," probably 
convinced also that a long life through many generations of 
routine civilized habit, with its luxuries and laissez faire, 
cannot be exchanged for the food, clothing and indulgence 
limitation of a non-policed forest life in a non-tropical 
country. And so the Island of Kabakon must get along 
yet awhile longer without Utopian philosophers among its 
population and Deutschland must endure them yet awhile 
longer at home. 

The primitive Arcadians, who apotheosized Pelasgus for 
having taught them the superior nutrient properties of 
acorns or herbs, their former diet, were not so cultivated as 
this coterie of misguided German savants, but they were 
no bigger fools, though they began their exclusive vege- 
tarian foolishness five or more centuries earlier, even a 
century or two before Oenotras and several centuries after 
the singular segregation of Evander. 

The breakfast chips and nut foods of the vegetarian! 
of our day originated along way back in gastronomic his- 
tory. The food cranks are not the sanitary innovator! 
some of them think they are. 

They are even antedated by the alchemists and the 



kditorial. 



93 



fountain of perpetual youth prospectors. The human mind 
often verges on insanity in its search after Arcadias, Eldo- 
rados, Sanitorias and placebos for the mind ill at ease. The 
discontent of that tired, depressed and dissatisfied feeling 
of cerebrasthenia prompts and promotes the seeking of 
many changes of environment. The hope of relief from 
the monotony and weariness of life probably prompted the 
bizarre seclusion experiment of these philosophers of Berlin. 
Before departing they should have consulted an alienist 
and neurologist like Mendel and his confreres in psychiatry 
and neuriatry there. 

PHYSIOLOGY AND THE PHYSICIAN.— Dr. Wesley 
Mills, author of Animal Physiology and professor of phys- 
iology, McGill University, in a recent forceful essay read 
before the June, 1906, meeting of the A. M. A., on the 
subject, "a physician's creed, past and present, as to the 
physiology of the heart," a subject upon which, from study of 
his work and personal familiarity with his methods, we re- 
gard him as expert, expresses the opinion "that physiolo- 
gists and physicians have stood too much apart. Although 
the American Physiological Society has held meetings for a 
great many years in the different great centers of the 
country, but few physicians ever attend those meetings or 
even read the reports of the papers presented, probably be- 
cause they are usually published in periodicals other than 
medical. 

In most instances teachers of physiology today are not 
men in active medical practice, while many never were 
doctors, except academically. This has its advantages, but 
also some disadvantages. Physiology as such, even yet, it 
is to be feared, is only occasionally brought before the 
student in the wards of the hospital or elsewhere when 
once he has passed the examinations on the primary sub- 
ject; while the medical investigator has been so occupied 
with morbid anatomy and bacteriologv that a physiologic 
medicine in the sense of one pervaded through and through 
with the conception that disease is altered function and the 
whole of medicine a study of this changed function, can not 



94 



Editorial. 



be said to be the dominant state of mind even yet, though 
one sees hopeful signs that progress is being made to- 
ward it." 

Referring to practicing physicians and surgeons, he 
says further: "For the latter, still more than the former, is 
apt to indulge in the belief that physiology is somewhat 
superfluous for his purpose, though I may point out that 
the surgeon who in our time has contributed most to the 
advancement of his art, Sir Joseph Lister, was himself a 
practical investigating physiologist, a fact which has made 
itself felt throughout his whole career." To all of which, 
the Alienist and Neurologist subscribes its full con- 
currence. 

At an earlier day, when taking official part by invita- 
tion in the conduct of the section on physiology of the 
Philadelphia Centennial Congress, the propriety of our so 
doing was questioned by some because we were not then 
an exclusive laboratory worker. 

The editor's address in medicine, in its neurophysio- 
logical aspects, at the California meeting A. M. A., was 
unfavorably criticised by some medical friends, of whom 
the author expected better things. Some of them know 
better now. They have made some neurophysiological ad- 
vances since then in the interpretation of the neural rela- 
tions and therapeutics of disease. 

But times have changed and men have changed and 
are yet changing with them. 

The consideration of morbid processes and pathologi- 
cal results and the relation of physiology to them, espec- 
ially in relation to the neurophysiology is more general in 
the profession now than then, though Cullen, whose dic- 
tum we adopted as our shibboleth at the founding of this 
journal in 1880, took a markedly neurological view of the 
processes of disease, a view to which the medical profes- 
sion must come again with the beaming sun soon to 
break into a flooi of neurological light on the "movements of 
the organism in disease," as Cullen saw them. 

We hope later to find time and space to further dis- 



Editorial. 



95 



cuss this interesting contribution to current medical litera- 
ture. In the meantime we commend it to readers of the 
Alienist and Neurologist . We take a personal pleasure in 
expressing our long indebtedness to our friend for the 
helping hand we have psychically held so long through his 
physiological researches. 

Dr. R. O. Beard, of Minneapolis, who also considers 
the subject (including microscopy) in its relation to the 
practice of medicine (St. Paul Med. Jour., Jan.,) says "that 
in the service of surgery and internal medicine alike, this 
branch of physiologic science is destined to fill an im- 
portant role. It offers to the general practitioner an ele- 
ment of added interest and accuracy in clinical observation. 
To the expert it offers an opportunity which will become 
greater, etc." 

And Krehl, discussing myocardial and neurogenic cardi- 
ac disturbances, urges more thorough study of these cases 
from a psychological and psychiatrical standpoint. — 
Muenchen - Medi^inische W ochenschrift . 

And so medicine moves forward on neurophysiological, 
as on other lines of observation, discovery and conclusion, 
for the betterment of mankind. 

A PSYCHIC BLOCK SYSTEM FOR RAILROADS.— 
The accident bulletin issued from Washington by 
the Interstate Commerce Commission for the three 
months ending March 31, 1906, shows the total num- 
ber of casualties to passengers and employes to be 3 8,296 — 
1,126 killed and 17.170 injured. 

The number of passengers and employes killed in train 
accidents was 274. 

The total number of collisions and derailments was 
3,490 (1,921 collisions and 1,569 derailments) of which 289 
collisions and 167 derailments affected passenger trains. 

The most disastrous accident reported, a collision caus- 
ing thirty-four deaths and injuring twenty-four, was due to 
a striking failure of the train dispatching system, according 
to the commission. A telegraph operator at a small station, 
who had been on duty all day and more than half the 



96 



Editorial. 



night, fell asleep, and on awakening, misinformed the train 
dispatcher as to what had occurred while he slept. 
The commission concludes after the statement "that 
the block system repeatedly advocated by the Com- 
mission is the true means that ought to be adopted for the 
prevention of such disasters, especially such as that caused 
by the over-time-exhausted and sleeping telegraph oper- 
ator." 

There is another and quite as important a block sys- 
tem for the prevention of accidents, and that is a rigidly 
enforced psychic block system that will block brain-tired 
and brain-weakened incompetency for all railway positions, 
when and where inaccuracy of brain work may menace life 
or mean death. 

A block system that blocks overtime work and off duty 
dissipation or other neglect of rest and sleep, is the need of 
the hour in railway and other responsible service. 

Neurasthenic, sleep-needing brains are out of place 
where insomnia is a duty and not a disease. 

Railway companies that secure adequate sleep to em- 
ployees will increase net earnings and diminish the injuries 
they inflict upon people who must travel on their now too 
heartlessly managed railroads. 

LOMBROSO AND THAW.— Caesare Lombroso has made a 
long range, premature and mistaken diagnosis of the men- 
tal state of Harry Kendall Thaw, the murderer of Stan- 
ford White, from an anthropological standpoint. Lombroso 
pronounces Thaw an epileptic moral maniac, a conclusion 
from the slight symptoms and mostly slight signs de- 
tailed by Lombroso, in which the clinically skilled -alienist 
cannot concur on the evidence (?) given by Lombroso. 
Thaw's sisters, brothers and his mother, now attend- 
ing the trial, show the facial and aural resemblances 
in features characterized as evidences of degeneracy and 
raising the presumption of epilepsy and moral mania by 
Lombroso, yet they have never displayed the "jealous 
homicidal obsession" which M. L. says was displayed by 
Thaw. To become a slave to one's passions may proceed 



Editorial. 



97 



from persistent indisposition to exercise proper inhibition and 
not necessarily from overmastering degeneracy. Dal- 
liance with sin by one pecuniarily above the necessity of 
daily counteracting labor is not prima facie degeneracy. 

But we shall have to defer criticism of this remarkable 
faux pas of the well-known criminologist for a more ex- 
tended and critical analysis, to be presented in our next 
issue. 

Thaw's madness can not be traced to an "unconquer- 
able instinct, or epileptiform" state due to the fact that 
"his father, in a few years, made himself from nothing to 
a millionaire." Such reasoning is supremely specious and 
fallacious, and unworthy of the true science/ of criminology 
or alienism. 

Deviations of form and feature "through accidents or de- 
fects of evolution and development, and likewise psychic 
eccentricities are not necessarily evidences of moral de- 
generacy, and anthropological inference of mental or moral 
perversion from them, are not always sound psychiatry. 

Even as we write, this "homicidally obsessed, degen- 
erate, moral maniac," is aiding his counsel in selecting the 
witnesses who are to judge him and his fatal act. 

Lombroso makes the same mistake here that he has 
made on another occasion concerning the degeneracy of 
Columbus. 

A RIGHTEOUS JUDGMENT ! — A righteous St. Louis 
City Judge lately decided that hot water in the external 
ear is a violent external injury. Suits like this reveal the 
unfeeling resistance to the just demands of those who 
place their trust and money in insurance companies and 
the trick juggling with the term "accidental violent external 
injury." Hot water in the external ear is certainly an 
external injury, but it is also internal and all external 
injuries that cause death must also act internally and 
become internal injuries. It's a wonder the insurance com- 
pany in its subterfuge resort, did not contest on the ground 
also that it was not the external injury, but the internal 
that killed. 



98 



Editorial. 



But there is a hidden, sinister purpose and rank injus- 
tice in this insurance phrase "violent external injury" and 
that is to bar out the many really violent concussional and 
cerebro- psychic shocks of accident to the neuraxis that 
undo one for life or a long period life, changing the mental 
nature and neurophysical ability for accustomed avocations, 
resulting from accidents on railway trains, automobiles, 
explosions, electric shocks and other collisions and other 
catastrophes that ruin the nervous systems and yet make no 
sign visible to the mind of the average railway surgeon and 
insurance medical examiner, or if mentally discernable by 
such medical men of wide knowledge of the nervou ssystem, 
they are not expected by their employing directing masters 
to see it, only through "violent external injury." It is a 
reproach to railway and insurance medical advisers and an 
evidence of unscientific knowledge of the susceptibility of 
the nervous system, that companies employing them have 
been erroneously advised that grave injury to the brain or 
spinal cord and peripheral nervous system, including the 
sympathetic, that injury to these nervous systems so vital 
to the life, liberty and happiness of individuals, can not 
occur without "violent external injury." 

Mentally lame medical monitors make vicious insurance 
company rulings. It is fortunate for insured humanity that 
we yet have courts to rectify such miserable medical mis- 
takes of conclusion. 

A better knowledge of the nervous system and the 
causes of its diseases would save the medical profession 
humiliation and the insurance companies such just judicial 
rebuke. 

APPEAL BY EDWARD S. MORSE, in Boston Herald, 
to stop steam whistles, and advising us of the painful fact 
that "within a few years there has come to us on steam 
railways a series of whistle signals which, in some towns, 
at least, have rendered life for many unendurable." 

In the appeal our attention is called to ordinance of 
city of Cleveland, Ohio, section 841. "Engine whistles. No 
whistles connected with any railway engine shall be sounded 



Editorial. 



99 



or used within the limits of the city of Cleveland, except 
as a signal to apply the brakes in case of immediate or 
impending danger. 

"Section 843. Stationary engines. No person shall blow 
or cause to be blown within the limits of the city of 
Cleveland the steam whistle of any stationary engine as 
a signal for commencing or suspending work or for any 
other purpose except as specified in the next following 
section. 

"Section 844. Nothing in this subdivision contained 
shall be construed as forbidding the use of steam whistles 
as alarm signals in case of fire or collision or other immi- 
nent danger, nor for the necessary signals by the steam en- 
gines of the fire department of the city." 

Detroit, Michigan and Newcastle, Penn., have passed 
similar ordinances, with penalties of fines and imprisonment 
for infringement. 

Mr. Morse would be pleased to know of any other 
town or city in which similar laws have been enacted. We 
hope St. Louis will soon be in the list of anti- needless 
noise cities. Great noises shock the nerves and injure the 
health of people, and should be abolished whenever 
practicable. 

Dr. C. C. Wiley of Pittsburg, Thaw's family physician, 
testifying as an expert on insanity, which few family 
physicians are capable of doing, is reported to have become 
badly confused under the merciless cross-examination of 
District Attorney Jerome and admitted that he was not 
familiar with the Romberg test for insanity, though he 
apparently, at first made the impression that he knew what 
it was. 

Now the Romberg test or the Brach-Romberg sign, as 
it is also called, is not a symptom of insanity, but one of 
locomotor ataxia or spinal sclerosis especially. Only the 
ataxic insane could have it and they are rare. An alienist 
might be expert in insanity and not know the significance 
in spinal sclerosis to which it especially belongs. 

He is also reported as "falling down" on the neural 



100 



Editorial. 



relations of the cardiac nerve, a branch of the pneumogas- 
tric, with cervical sympathetic relation. 

There are so many hundreds of nerves and more 
branches that any man might miss in such anatomical 
memory and yet understand the brain in relation to insanity. 
Both of these were irrelevant catch neurological and not 
psychiatrical questions, just as the Argyll- Robertson pupil 
question was, None of them were germane nor fair and 
would have been ruled out by the court, if court and 
attorneys knew how irrelevant they were to any question 
in psychiatry. 

Dr. Wiley certainly made a grave mistake in saying a 
dilated artery was not diseased. The walls of an artery 
may dilate through direct disease, as in aneurism or hyper- 
emia from direct cardiac over-pressure or vasomotor pare- 
sis, etc. The district attorney did not however help his 
cause by confusing this witness. The facts observed will 
be noted by the jury. 

PSYCHIC SANITARY SENSE COMING TO THE SEN- 
ATE.. — Daily Time Limit to Railway Service. — By a vote 
of 70 to 1, the Senate January 10th passed a bill providing 
that railway employes engaged in handling trains shall not 
work more than sixteen consecutive hours, which period is 
to be followed by ten hours off duty. The one negative 
vote was cast by Senator Pettus. 

The act, unfortunately, only applies to "trains doing 
an interstate or foreign commerce business." Amendments 
provide for extraordinary exigencies, as for accidents and 
delays and obstructions in consequence thereof. 

Such a law should be among the statutes of every 
state, in the interests of health and life of employes and 
the public. Railway management efforts to annihilate time 
of brain rest and make the brain a perpetual motion machine 
should cease. Smart railway management should seek 
economy and the making of dividends in other ways than 
by overstraining, unresting, and prematurely wearing out and 
weakening, for train wreck results, the brains of railway 
employes. 



Editorial. 



101 



The people as well as the railway service have rights 
to healthy, clear acting, vigorous railway service brains, 
that can always do the right thing, at the right time, for 
the traveling public's safety. Some American railways' 
managers appear respecting the demand upon employes as 
if they were themselves brain- weakened by water on the 
brain. 

THE PROFESSIONAL ENDEAVOR in the direction of 
abstention from the far too liberal alcohol prescribing 
of the past, coupled with popular awakening to the brain, 
body and mind damage of alcoholic daily drink, gives hope 
of escape from what has been and still is a menace to man- 
hood and national decadence, among the causes that threaten 
the undermining of civilized mankind. 

Wise political communities seeing alcohol's destructive 
power in the portrayals of pathological science, revealing 
alcohol's organic ravages of brain, other viscera and the blood 
vessels and the blood's disordered quality and movements, 
are taking, or have taken, defensive action. Science only 
reiterates the teaching that wine, as a health promoter is a 
mocker, and "whosoever is deceived thereby is not wise." 
Who hath redness of eyes and blossoming nose and florid 
face from daily drink hath also redness and more or less 
congestion of brain and stomach and other organs, because 
of morbid vasomotor dilation and the "wounds without cause" 
external, of the inebriate, are wounds from morbid states of 
brain. 

An agency that causes paresis and instability of psy- 
chic and psycho-motor neurones and their later more de- 
structive consequences is not an agent for the safe and 
sane of thought to habitually use, nor is it fit for indiscrim- 
inate prescription by physician, priest, trained nurse or 
patient. 

ETIOLOGY OF SPEED MANIA. — The St. Louis Repub- 
lic, noted for its forceful editorial utterances, makes the fol- 
lowing comment on a recent communication by Dr. Lee 
Howard, quoted in the British Medical Journal, referring to 
the motor speed mania: 



102 



Editorial. 



Doctor Lee Howard, is quoted in the British Medical 
Journal to the effect that the delight in fast automobiling 
and the craving for strong drink are etiologically the same 
thing. 

A feature of the present age, he believes, is the in- 
creasing tendency toward explosions of psychic energy, 
one objective symptom of which is the mania for high 
speed, and others the drug mania and the alcohol mania. 
It is observable that explosions of psychic energy corres- 
pond with those of gasoline, which fact suggests the advisa- 
bility of carrying some sort of a spark-plug in the hat of 
those dangerous beings whose psychic excess energy pre- 
disposes them toward reckless driving. 

But, it is doubtful in point of fact — which seems to 
contradict the eminent physician's theory— whether a crazy 
chauffeur has an excess of real psychic energy. His cere- 
bral coils probably generate very little. But it is conceiv- 
able that buck beer or rye highballs might stimulate his 
convolutions and excite a craving for speed, while fast 
driving is known to have a pronounced effect on thirst. 

Thus, we suggest for the distinguished doctor's consid- 
eration, a vicious circle might be created. Etiologically the 
relation of booze, benzine and the bughouse is plain 
enough if we adopt the more practical and less scientific 
viewpoint. 

ADEQUATE TIMELY SLEEP FOR THE NORMAL MIND, 
as well as the abnormal, is a recognized essential of psychic 
sanitation in the estimation ©f alienists, neurologists and 
physicians in general, though it does not yet appear to 
have received the consideration it deserves from those who 
demand and dispose of the mental work of others, especially 
in the railway service, in witness whereof we cite the fol- 
lowing, to be added to many other and more disastrous 
brain strain requirements of our American railway manage- 
ment, but none more cruel and criminal on the line of 
unremitting brain work demanded. 

Last November, seven men, the crew of a Lehigh & Hudson 
freight engine, who had been in continuous service three 



Editorial. 



103 



days and three nights, went to sleep on the locomotive 
while it was on its way from Franklin Junction to Phillips- 
burg. All hands were asleep when the engine went through 
the yard at this place, passing the red light turned against 
them. 

The telegraph operator here wired a message to the 
operator at Martin's Creek, the next station down the line, 
to be on the lookout for the engine. Its speed was con- 
siderably reduced when it reached that station, and the 
operator succeeded in boarding it, and preventing a collision 
by running the locomotive to a siding. 

The fire was hastily pulled from under the boiler to 
prevent an explosion, the water having reached a very low 
point. 

OUR PROPRIETARY PHARMACEUTICAL ALLIES.— It is 
conceded the world over that the best sort of proprietary 
therapeutic firms have given to the medical profession 
many elegant and agreeable formulae of valuable but other- 
wise unpalatable medicines. Among these can be men- 
tioned pleasant combinations of cod liver oil and the 
pepsins and the enzyme class. Certain pharmacists have 
advanced the profession a century in knowledge and use 
of certain drugs, such as the Parke-Davis specialties. 

Others have given us American products where we had 
before relied on foreign markets, such as the Powers & 
Weightman quinine, the Fairchild Brothers & Foster's 
enzymes, Squibb's chemicals, etc. 

Combinations of definite and certain strength, like Bat- 
tle's bromidia and Peacock's bromides, have especially 
helped the young country doctor not perfected in phar- 
macy and looking about for plain, palatable, ready pre- 
pared formulae of certain ingredients easily dispensable. 

The danger in the use of these agencies is not in the 

drug, but in their unwise prescribing in ordering them by 

the bottle, to be taken at the discretion of the patient. 
But the same danger exists in ordering any drug 
of the hypnotic class, or in fact of almost any 
kind, and leaving its renewal and continuance to the dis- 



104 



Editorial. 



cretion of the patient. Medicine prescribed for repetition 
at the discretion of patient or druggist almost always proves 
a source of greater harm than final benefit. 

IN LINE WITH THE ADDRESS OF VICTOR HORSELY, 
before the Canadian meeting of the 8. M. A., is the appeal 
for more milk and less beer for the babes and mothers 
of England and Wales, in the face of the infant mortality 
of last year, viz: one hundred and twenty thousand 
babies dying there last year, making even the fittest unfit 
to live, as Sir Henry Campbell Bannerman said. Pure 
milk depots for babies and mothers in lieu of beer are the 
remedies, and the medical advice for nursing mothers of beer in 
lieu of better nutrition is an exploded fallacy. The milk 
depots have already done much good, as Minister John 
Burns lately attested. 

He found that the deaths in the sterilized milk fed area 
ranged from 50 to 100, while in other areas the death-rate 
was from 100 to 273. In the face of figures like that it 
seemed to him that the milk depots experiment, incomplete 
though it had been, was an experiment that warranted 
careful development and rapid extension. The bill on the 
subject is now in draft. 

He said that one of the chief contributing factors to- 
wards the high mortality was the tendency on the part of 
people to spend on beer what they should spend on food 
for their infants, and on leisure and rest for the mother. 

It is gratifying to medical science to see more cor- 
rect common sense and enlightenment taking hold of 
and swaying the people in regard to the too long enter- 
tained delusion that alcohol is a sort of support and food 
substitute in its many seductive beverage forms, as if any 
blood and brain cell poison could be good for habitual daily 
use. 

"LEGISLATIVE SCHEMES OF THE AMERICAN MEDICAL 
ASSOCIATION."— In nearly if not all the State Legislatures 
now in session, bills have been introduced which seek to 
compel manufacturers of proprietary and patent medicines 



Editorial. 



105 



to make public the formulas and private processes by 
which their preparations are made. A bill of similar im- 
port, dealing with interstate traffic in medicines of this 
class, has also been proposed in the House of Representa- 
tives at Washington. 

The large number of these bills, their apparent spon- 
taneity, and the noisy clamor of their advocates, would 
make it appear that the American people had suddenly 
awakened to the realization that they have long been vic- 
tims of some monstrous wrong. — Abstracted from <( Legis- 
lative Schemes ," sent out by the American Journalist. 

And this is the monstrous truth so far as concerns a 
certain number of the many new name-blind combinations 
offered to the medical profession for prescription on faith 
rather than that definite knowledge of composition neces- 
sary for intelligent prescription and the gleaning of ac- 
curate therapeutic knowledge. 

"Sight -Unseen" lawyer and doctor choos- 
ing. — Secretary Shaw tells this story on Congressman 
Smith, of Iowa, according to the St. Paul Pioneer Post. A 
prisoner arraigned before the criminal court. Present in 
court room: Lawyers Smith, Brown and Greer. 

"Where is your lawyer?" inquired the Judge. 

"I have none," responded prisoner. Haven't any money. 

"Do you want a lawyer?" asked the Judge. 

"Yes, Your Honor." 

"There is Mr. Smith, Mr. Brown and Mr. Greer," said 
the Judge, pointing to the young attorneys awaiting brief- 
less and breathless for something to turn up, "and Mr. 
Alexander is out in the corridor." 

The prisoner eyed the budding attorneys in the court- 
room, and after a critical survey stroked his chin and said, 
"Well, I guess I will take Mr. Alexander." 

And this is the way many people also select their phy- 
sician. They wait until some emergency demands immediate 
medical aid, and then they have some one suggested on 
the spot and of whom they know only that he belongs to 
the profession. 



106 



Editorial. 



AN ALCOHOLIC DRUNK THEFT OBSESSION.— A 
young minor, Geoffrey Ryan by name, of St. Louis, without 
previous criminal record of the kind, after several drinks of 
whisky unlawfully sold to him, stole a buggy in the West End 
and proceeded to hold up (with a pistol that would not go off) 
and rob, under influence of a daring, alcoholically-excited 
frenzy, one pedestrian after another, till he had robbed on 
the streets more than half a dozen in the short space of a 
few hours in the evening, when he was taken into custody 
by the police. 

His predatory performance was not characterized by 
much more discretion than a procursive epileptic might dis- 
play, save that being in a buggy and stopping to halt and 
hold up his victims, served unwillingly to disarm pedestrians 
of suspicion of the robber. 

Excise Commissioner Mulvihill is acting the part of 
the good psychiatrist and Samaritan by seeking to find and 
annul the licenses of the saloons who unlawfully furnished 
the boy drink. 

ALL NIGHT AND EIGHT HOUR LABOR SHIFTS FOR 
THE CANAL ZONE. — We are approaching the time when 
there will be, as there should be now, with the aid cap- 
ital and invention have given to labor, three daily shifts for 
the world's work. It should be inaugurated for humanity's 
sake and the best of sanitary reasons at the Panama 
Canal, The work there for all is arduous, the atmosphere 
is not salubrious, to say nothing of the anophile mosquito that 
breeds the deadly Chagres haematuric malarial fever and the 
stegomia faciata that causes yellow fever, now happily 
nearing extinction there through the sanitary work of the 
U. S. government through Colonel Gorgas and his medical 
co-workers. The facility with which electric light can now 
be made and placed, would make possible the working of 
night shifts on the Canal route, and light all night would 
be salutary to health throughout the entire canal zone. 

CONDITION OF CUBAN INSANE ASYLUM.— One thous- 
and six hundred patients crowded into quarters with ca- 
pacity for but four hundred. Last October Governor 



Editorial. 



107 



Magoon visited the National Insane Asylum at Havana and 
discovered a deplorable state of affairs there. 

"One thousand six hundred and sixty persons of both 
sexes were crowded into filthy and dilapidated buildings, 
with a capacity for four hundred persons only. They are 
sleeping on broken cots, relics of the last American occu- 
pation. 

"Congress made an appropriation to enlarge the asy- 
lum, but the money was never expended." 

We note with pleasure that Governor Magoon will 
take steps to erect a decent building and remedy the de- 
fects in provision. 

HYSTERICAL MONOPALSIES.— It is well to continue 
the record of these cases as they are sure to keep alive the 
fact of mind cure, possibilities and the explanation of the 
marvellous (! ) results of mind and faith cure christopathic, 
osteopathic, and other methods of psychic impression. 
Three cases of this kind were reported by Dr. C. C. 
Hersman in Jour. A. M. A. last year, one resulting from 
fright and the other two from traumatic shock. The arm, 
leg and diaphragm were the seat of the local manifestations. 
The spasms would last for several hours. These cases 
prompted Dr. H. to ask if there is an irritating or para- 
lysing center within the cortical psychomotor centers. 
Are these nerve center neurones at this time bathed in 
irritating cerebro-spinal fluid? In other words does some 
decrease in metabolic elimination cause transient increase 
of cytotoxins? This question has been asked before in 
regard to epilepsy and affirmatively answered in the minds 
of some neurologists. 

THE ACHING TOOTH AND THE MOTORMAN. — An 
Eastern street car motorman stopped and left his car to 
get his tooth pulled. On his return, minus the tooth, the 
patient, sympathetic passengers cheered and the car moved 
joyously on, the crowded sitters and swaying strap-hangers 
forgetting their own misery in the happiness of the man 
whose distraction was relieved by the extraction. And the 



108 



Editorial . 



company continues to "pull the public's leg," as usual, 
with the customary, inadequate accommodation. 

The pull of a traction company with the "powers" of 
most American cities is stronger than a dentist's tug at a 
tooth that won't come out, except when they tackle the 
dens sapientiae. Dens sapientias is easy in the dentist's 
hands, like the public in the hands of the traction manage- 
ment. 

AN ANDROID WOMAN HOMOSEXUALITY CONJU- 
GALLY MATED to a woman, or a gynesiac man, has been 
lately puzzling the daily press, especially in Chicago, in the 
person of Nicolai de Raylan, husband of Mrs. Anna Da- 
vison de Raylan. Nicolai de Raylan is described as beard- 
less and otherwise effeminate in appearance, and with the 
usual reportorial embellishment, he is described as shaving 
four times a day, ineffectually endeavoring to develop a 
beard. 

He was for thirteen years secretary to Baron Schlip- 
penback, Russian Consul. He is reported to have died at 
Phoenix, Arizona, where through a coroner's autopsy his 
true sex was discovered. 

THE NAME OF THE JOURNAL OF The Association of 
Military Surgeons of the U. S. has been changed with the 
issue for January, 1907, to "The Military Surgeon" and 
we take pleasure in noting the fact, as the abbreviated name 
sounds better and means as much. This good journal has 
been highly successful in its brief career of six years as the 
pioneer military medical journal in the English language, 
under the able and judicious editorial direction of its secre- 
tary and editor, Maj. James Evelyn Pilcher, Brigade Surgeon, 
U. S. V., Captain (Retired) U. S. A. and its distinguished 
managing corps of military medical men. 

LORD ROSEBERY'S BRILLIANT IDEA OF THE CAUSE 
OF THE INCREASE OF INSANITY.— The London Spectator 
reports the distinguished Englishman as saying at the ded- 
ication of a hospital for the insane, he found it extremely 
difficult to discover any convincing reason for the increase 



Editorial. 



109 



of insane, and he could only suggest that the asylums be- 
came fuller because it was impossible for the people with 
slow-moving brains to keep pace with the times in which 
we lived. 

BEVERLY FARM SCHOOL, located at Godfrey, Illinois, 
for the rearing of backward children, sends out an attract- 
ive illustrated pamphlet, showing its advantages in loca- 
tion, building and equipment. Dr. W. H. C. Smith, the 
able superintendent, and his capable and accomplished 
wife, the matron, have been long and faithfully engaged in 
this important work. Their former experiences were at 
Elwyn, Pennsylvania, and at the Illinois State Institution, 
at Lincoln. 

THE STUDY OF MENTAL DISEASES.— We endorse the 
following from the Medical World: 

In no other department of medicine is the great major- 
ity of general practicians so deficient and so negligent and 
so absolutely ignorant, as in the domain of mental affec- 
tions. The average physician has never been taught any- 
thing about mental diseases, and consequently he does not 
know anything about them. The recent failure of Dr. 
Wiley, as an expert in the Thaw trial, is an illustration. 

THE LIFE COURTEOUS.— It is the little courtesies 
that we have learned, as human beings, to extend to 
one another that, almost more than anything else, make 
life worth living. Bad manners and bad breeding are 
among the offenses that make the way we travel the 
harder to endure. And the worst of it is that men ap- 
pear to be no better in this respect now than they were 
before they had books to read, forks to eat with and street 
cars to ride in. 

TO AWAKEN EVERY PSYCHIC NEURONE in collateral 
chains of thought, the neurologist may read with profit and 
pleasure "Internal Secretion," by E. C. Hooper, B. A., M. 
B., Asst. Dem. Anat., University of Toronto, it being the 
president's address before the Toronto Medical Society. 



110 



Editorial. 



A PSYCHIC SPASM OF UNWRITTEN LAW HOMICIDE 
is traversing the country, and in St. Louis it has reached 
the colored people. A negro proprietor of a city saloon 
stabbed to death another negro because of the latter's 
being too attentive to his wife. See our next issue for paper 
on the subject. 

ACKNOWLEDGMENT OF INVITATION to be present 
at the commencement exercises of the Training School for 
Attendants in the State Hospital at Danville, Pa., Thursday 
evening, July 12, 1906, is here recorded with expressions 
of thanks and gratification that this good work continues in 
this and other similar American hospitals. 

POLICE EUTHANASIA IN SAN FRANCISCO.— In San 
Francisco, during the great earthquake and fire, a policeman 
was seen futilely struggling with others to rescue a man 
pinioned in burning wreckage. The helpless man felt the 
fire begin burning his feet and begged to be killed. The 
officer took his name and address and shot him through 
the head, killing him instantly. 

QUININE AS A DEFENSE OF CRIME found recent ex- 
emplification in the plea of a mother for her 18-year old 
son before a St. Louis city criminal court, convicted of 
stealing a horse and buggy and accomplishing seven 
"hold-ups" and found "with the goods," in one night. 

The prisoner admitted taking whisky after the qui- 
nine, and was arrested in a saloon. 

DR. JAMES L. GREENE, for five years superintendent 
of the Nebraska Hospital for the Insane, at Lincoln, has 
tendered his resignation to Governor Mickey, to take effect 
July 16. 



Editorial. 



Ill 



Dr. Greene has accepted the tender of the super- 
intendency of the Illinois Hospital for the Insane at Kan- 
kakee. 

TWO INSANE FRATRICIDES IN ONE FAMILY and mur- 
derous deeds done near the same time, but in different 
places in St. Louis, are on record for 1906, as per the fol- 
lowing verified news item of January 23rd, 1907: 

''John C. Straub, who killed his brother, Charles, in 
Caesar's Cafe, and Edward Croissant, who killed his 
brother, Albert, at Fourth and Locust streets last summer, 
were taken to Farmington yesterday to be confined in the 
State Asylum for the Insane." 



IN MEMORIAM. 



DR. A. V. L. Brokaw died at his home of gastric 
hemorrhage, a sequel of La Grippe, the fatal sequellae 
of which have not as yet been named. 

The treacherous character of the grip as a toxic neu- 
rosis, impairing the arteriole control and damaging the 
vascular coats, is revealed in the history of our dead friend, 
for he had arranged for a recuperative trip to New York 
City day before yesterday, and yesterday January 25th he 
died. He contracted his malady last spring, but heedless, 
as too many, even medical men, are of the insidious, con- 
tinuing toxic hold of this persisting disease of the vital 
nerve centers, he continued his important onerous work as 
chief surgeon of the United Railways company and surgical 
head of St. Johns Hospital staff and "fell in the line of 
duty." He was stricken, as it were, with the knife of his 
art in his hand. 

For his years (but 43) he was preeminent in his pro- 
fession, his surgical judgment and skill were excellent and 
he had made his mark on the profession as a man of large 
opportunities and extensive work, equal to all of the exacting 
demands of his arduous positions. 

It has never been said of him by those who knew him, 
as has been and can be said of too many operating sur- 
geons, that he was a better operator than diagnostician, 
that the skill of his hand exceeded the judgment of his 
head. He was a cautious but bold and successful operator. 

Kindly in his personal and family relations, charitable 
toward his needy patients, appreciative of his own surgical 
skill, yet modest in his estimate thereof, and of his personal 
merit, the profession misses and mourns him. He was an 
honored member of many medical bodies who will miss him 
from their councils. 

He has fallen from the ladder of surgical fame he seemed 
( 112 ) 



In Memoriam. 



113 



securely climbing, all too soon for the hopes of his friends. 
For the top was in sight and now he is down and dead. 

We tender his aged father, our boyhood's senior colleague 
as interne in the U. S. Marine hospital and to his wife and 
all of his bereaved family, the sympathy of an appreciative 
personal and professional friend. 



The death of John F. Magner, editor of the Star- 
Chronicle, January 27th, takes from St. Louis and the world 
a prominent and forceful figure in the right sort of jour- 
nalism, a journalism that always considered and plead for 
the good of the people. He was ever on the alert against 
the forces of evil and was preeminently mindful of the 
moral, sanitary and political welfare of St. Louis. 

He was well trained by liberal education and a culti- 
vated knowledge of men, for his sphere of action. With 
his pen he fought for the true, the good and the pure, 
with the rigorous valor of one "not mailed in scorn, but 
clothed in the armor of a pure intent," hence the force 
and pungency of what he wrote. No pandering to evil, 
"no unjust gain increased his substance." He was the 
true type of editorial writer for true lovers of the right and 
good in personal and public life. 

The sun of his journalistic usefulness "set while it 
was yet day," and with the setting sun he dropped from 
the zenith of highest journalism "like a falling star." 

Had he the opportunity and a longer lease of life he 
would have been another McCullough in American jour- 
nalism. 

Who lives and writes as Magner did, lives not and dies 
not in vain. 

From a long and familiar acquaintance in most intimate 
relations from the time he first began to break with that 
hyperemic yielding to brain-strain common, in varying 
degrees, to great and constant writers, especially editors 
forced to think much and fast under merciless coercive 
brain pressure by imperative environing demand, we learned 



114 



In Memoriam. 



much of Magner's purity of purpose, his power of brain 
and mind and his fidelity to the duties of his great pro- 
fession. From relationship we regarded him as not only 
great and good in our humble esteem, but he was pro- 
nounced great and good by mouths of wisest censure in 
his profession and even those living under the gilded glamor 
of evil, who felt the sting and smart of his blows for 
the right, approved their virtue, while seeking to escape. 
He was built too strong for the foes of virtue "ever to 
expugn." 



Dr. Alonzo Garcelon, the nonogenarian Nester of general 
medical practice, is dead and strangest of all dead because 
of an accidental gas asphyxiation. Born in Lewiston, Maine, 
n 1813 and a graduate of a famous Maine medical college 
(Bowdoin) he lived his life mostly and died in his native city. 
He spent a part of his life as Representative, Senator, 
Surgeon General and Governor of his native state. He 
had always been a worthy and prominent figure in the 
profession and the politics of his state. His friends were 
many, his enemies few and feeble and those who loved 
him loved him well for his virtues, his warm-hearted 
attachments and for the sort of enemies he made. The 
most prominent surviving member of his family is our 
friend, the retired Vice-President and Superintendent of the 
Pullman Palace Car Company, to whom with all who may 
yet remain of this veteran physician's and noble man's 
family we tender our sympathy. We feel yet the last 
impress of his kindly eye and cordial hand as we felt them, 
not long ago, at a meeting of the A. M. A., which he loved 
so much. 



Dr. William James Herdman, professor of nervous dis- 
eases and electrotherapeutics in the University of Michigan, 
died on December 14th at the age of fifty -eight years in a 
private sanatorium in Baltimore, where he had gone to 
have an operation performed. 

A good man gone too soon. Herdman was g-enial in 
personality, capable as a teacher, competent and enthusi- 



In Memoriam. 



115 



astic in practice, broad of culture and true and hearty in 
his friendship. As we miss him so we tender to those 
who were nearer to him our condolence. 



Alexander E. Macdonald, LL. B., M. D., a member 
of the New York Psychiatrical Society, died December 
10th, 1906. 

For thirty-five years Dr. Macdonald had been intimately 
associated with the insane. He commenced the study of 
medicine at Toronto University and graduated M. D., Med- 
ical Department, New York University, 1870, LL. B., Law 
School, New York University, 1881. Lecturer upon Medical 
Jurisprudence in 1874; subsequently, Professor of Medical 
Jurisprudence, Professor of Psychological Medicine and Med- 
ical Jurisprudence, and was Emeritus Professor at the time 
of his death. House Physician Hospital for Epileptics and 
Paralytics, Blackwell's Island, 1870; chief of staff, Charity 
and Allied Hospitals, Blackwell's Island, 1871. Resident 
physician, New York City Asylum for the Insane, Ward's 
Island, 1874. Medical superintendent of the same from 
1874 to 1904, the title of the asylum having been changed 
in the meantime to Manhattan State Hospital, East, Ward's 
Island. 

In 1901 he established the tent treatment of the tuber- 
culous insane, removing them from all communication with 
any unaffected patients. The principles underlying this 
undertaking are now universally accepted by the medical 
profession here and abroad. 

An article on this subject was published by the Charity 
Organization of New York City and the National Associa- 
tion for the Study and Prevention of Tuberculosis. 

Dr. Macdonald was a delegate from the American 
Medico- Psychological Association to the Fourteenth Inter- 
national Medical Congress at Madrid in 1903; President of 
the American Medico- Psychological Association in 1904; 
delegate to the Congress of American Physicians and Sur- 
geons, to be held in Washington in 1907; honorary member 
of the Medico- Psychological association of Great Britain 



116 



In Memoriam. 



and Ireland, and of other continental medical associations. 

His splendid administrative abilities made him familiar 
with every detail in the care of the insane, seven thousand 
at one time being under his direction. He possessed the 
rare gift of attracting to himself experienced, trusty and 
loyal officers and friends. 

Dr. Macdonald was one of the most distinguished 
alienists of this country, and a man of striking force of 
character. He had a hatred of cant and pretense. His 
far-seeing powers, his unswerving integrity and great 
executive ability qualified him in an extraordinary degree 
for his responsibilities. At all prominent medical meetings 
his activities were conspicuous. His commanding presence 
and lofty sense of duty will always be remembered by 
those who had the privilege to be acquainted with him, 
and his pupils in all parts of the country will pay many 
tributes to his memory. 

We join in condolence. The deceased was, as from 
long acquaintance we can attest, a man of distinguished 
merit in the ranks of psychiatry and a true physician and 
friend, adorning his profession and society. 



SELECTIONS. 



CLINICAL NEUROLOGY. 

DOUBLE CONSCIOUSNESS BEFORE THE AMERICAN 
NEUROLOGICAL ASSOCIATION.— The following cases were 
recorded and discussed at the June, 1906, meeting at Boston: 

A Case of Double Consciousness, Amnesic Type. By 
Dr. Edward B. Angell. The subject of the sketch, a 
frank, open-hearted Englishman, was married on Christmas 
last, and within a few days had disappeared from home. 
Some ten days later a somewhat incoherent letter from 
him to his wife located him, and he was brought 
heme in a dazed and somewhat confused state of mind. 
The mental condition so closely resembled hypnotic state 
that it suggested a means of treatment. Under hypnosis, 
easily induced, the suggestion was made that on awaken- 
ing his mind would be clear. . Such was the result, and 
gradually he became alert, clear-minded and able to dis- 
criminate between the unreal, dreamy states of conscious- 
ness and the real facts of normal existence. For a dreamer 
of dreams his altered personality disclosed him to be. The 
tale he told first differed materially from a later one, while 
both became radically changed when normal consciousness 
had become established. He had assumed a name under 
which he was married, different from his own, insisted upon 
a genealogy, which was fictitious, claimed a college educa- 
tion and a service in South Africa, which he had not ex- 
perienced; in fact, much of his memory registration was 
absolutely wrong. Careful investigation disproved most 
of his experiences. His tales were but creatures of 
an unstable imagination. His consciousness, when in the 
abnormal state so akin to hysteria, registered fact and 
fiction alike; no discrimination being made between 

( 117) 



118 



Selections. 



objective fact and subjective image. Such is the condition 
of the hypnotic. There is a subjective, unconscious falsi- 
fication of memory, a species of amnesia, for the real 
events of an uneventful existence and the gap is filled 
with visions, with real unrealities, with plausible impossi- 
bilities. If the facts of such dual existence could be 
proven much that has been accepted as actual occurrences 
during the dispossession of the ego would be found illus- 
ions. They are but shadows of reality, misty radiographs 
which rapidly fade from the mind when Richard is himself 
again. In the present instance the honesty of purpose and 
frankness of mind are unquestionable. Whatever be the 
nature of this disturbance of mind it is real, not fictitious. 
Memory is unstable, not character. 

A Case of Alteration of Personality. — By Dr. Richard 
Dewey. An alteration of consciousness of sixteen days' 
duration in a girl of twenty-three, not amounting to double 
personality, being incomplete and of rudimentary form. The 
symptom-complex embracing a history of migraine, hys- 
teria and an eroto-mania of homo- sexual character. The 
altered consciousness being preceded by an evolution of 
systematized delusions (or pseudo- systematized delusions 
invented by the patient.) The altered personality consist- 
ing in an assumption by the patient of the name and 
character of a person known to her and in authority over 
her. There being also a total change of handwriting dur- 
ing the sixteen days, the same being vertically upside 
down and horizontally reversed; i. e. running from right to 
left. 

A Case of Double Consciousness. — By Dr. Edward B. 
Angell. 

Dr. Gordon said in the April number of the American 
Journal of the Medical Sciences will be found an article 
by him on double ego that deals with a case much like the 
cases described today. It was the case of a young man 
above the average intelligence. It happened several times 
that the manager of the place where he worked would 
give him an order to do a certain thing and he would not 
obey, while in. other circumstances he would do it at once. 



Selections . 



119 



Sometimes he would raise his hand to strike his wife, 
while at other times he was known as a most loving hus- 
band. When reminded of it, he would be surprised. The 
amnesia was complete. At the present time the patient 
presents this peculiar condition. By a process of mental 
analysis he has arrived at the conclusion that probably he 
is composed of two beings. There is No. 1 and No. 2, 
and No. 2 is independent of No. 1. He gave a number of 
instances in which he heard No. 2 ordering him to do a 
certain act. 

Now the question is in all these cases: What is the 
nature of the disease which is responsible for this peculiar 
condition? Dr. Gordon believed the case which he re- 
ported to be one of epilepsy. Dr. AngelPs case he be- 
lieved to be a case of epilepsy. The attacks of motor 
aphasia are very suggestive of epilepsy. Dr. Dewey's 
case, it seemed to Dr. Gordon, is a clear case of hysteria. 

Dr. Angell said he appreciated the possibility of masked 
epilepsy as being the cause of this condition. However, 
careful investigation failed to reveal any indication of the 
motor symptoms of epilepsy, or even any symptoms sug- 
gestive of petit mal. 

CHOREA. — Poynton and Holmes come to the conclus- 
ion that chorea is a manifestation of acute rheumatism and 
that the diplococcus rhematicus is the infective agent in 
rheumatism. Duckworth regards chorea as a neurohumeral 
disorder. He contends that the predisposing factor which 
determines an attack of chorea in a rheumatic subject is 
the neurotic element. Chorea is considered to be cerebral 
rheumatism. 

Langevin advocates absolute rest in bed, a strict meat 
diet, hydrotherapy and gradually increasing doses of anti- 
pyrin. The administration of antipyrin must be carefully 
watched, and its use should be superseded in the event of 
albuminuria, weakness of the pulse or other toxic mani- 
festations. 

Thayer found that of 689 cases of chorea observed during 
one or more attacks, 25.4 per cent showed evidences of 



120 



Selections. 



cardiac involvement. In many cases fever was pres- 
ent. Thayer concludes that there is good reason to be- 
lieve that the presence of fever in otherwise uncompli- 
cated chorea is, in a large percentage of cases, associated 
with a complicating endocarditis. — Courier of Medicine. 

RABIES. — Babes accepts as the actual parasite certain 
fine granules — round, black or blue (with the Cajal-Geim- 
sen stain), found exclusively in the protoplasm of the de- 
generated nerve cells in the most severely affected parts 
of the nervous system. Babes looks upon Negri's bodies 
as representing encapsulated forms of the parasite, in a 
phase of involution or transformation. It must be admitted 
that Negri's bodies are generailv conceded by investigators 
to be the cause of rabies. — Courier of Medicine. 



REVIEWS, BOOK NOTICES, REPRINTS, ETC. 



SAUNDERS' COMPLETE CATALOGUE of medical and sur- 
gical books, revised January, 1907; illustrated. W. B. 
Saunders Company, 925 Walnut street, Philadelphia, Pa. 
Every illustration shows how to do something and is 

on this account alone especially valuable. All the books 

are by the best of authors, and the entire catalogue is 

worth a worthy place in your library. 

WOMAN. A treatise on the Normal and Pathological Emo- 
tion of Feminine Love, by Bernard S. Talmey, M. D. 
Published by Practitioners Publishing Co., 62 West 
126th St., New York City. Price: Small octavo, with 
flexible leather covers, $3.00. 

The pathology of the female sexual life and functions 
from the psychical point of view are of more importance 
than has been generally considered both within and with- 
out the profession. There is no concise scientific work 
treating this subject like the present book, exclusively de- 
signed for use by the general practitioner. The physician 
seeking elucidation on anv pathological phenomenon of fe- 
male amatory emotions has to work his way through big 
volumes on psychiatry, legal medicine, philosophy, etc., 
before he can find more or less complete information on the 
subject in question. Many a family tragedy, having had 
its origin in an anomaly of some female sexual function, 
might have been averted by judicious advice and treatment 
from the family physician if he had understood the root of 
the evil. 

The author of Woman has endeavored to provide the 
medical, and to some extent also, the legal profession with 
a work especially devoted to this one subject, "Feminine 
Love," facilitating the study of the physiological and path- 
ological phenomena of the feminine sexual functions. 

( 121 ) 



122 



Reviews, Book Notices, Reprints, Etc. 



This work is useful to the physiologist, gynecologist, 
alienist, neurologist, general philosopher and anthropological 
savant. 

The sexual- instinct, libidio and its symptoms, orgasm, 
sexual potency, frigidity, nymphomania, masturbation, homo- 
sexuality, bestiality, essentials for a happy union, hygienic 
duration of intercourse, sexual life in relation to offspring, 
morality, etc., are among the subjects treated. 

The book deals cursorily with conditions of sexual 
perversion and degeneracy in woman, as Krafft-Ebing, 
Moll and others have done with both sexes, but in less 
indelicate detail. 

Twashtri? conception of the creation of woman, the 
psychological and utilitarian reasons for chastity, eros and 
libido, the prevention of masturbation. 

The author justly decrys the excessive lasciviousness 
and voluptuousness of the day and the causes thereof in the 
abuse of liquors among women, which has reached alarm- 
ing proportions among them, the modern dance and stage, 
nude and vulgar art, impure literature, "the modern novelist, 
who delights in descending to the gutter for his heroes," 
but we do not notice that he mentions the bill board and the 
newspaper. 

"All these artificial excitements tend to create volupt- 
uousness and this, says Scott, has as its indispensable 
consequence, degradation of a large number of women." 

STARR ON iNERVOUS DISEASES.— Organic and Functional 
Nervous Diseases. By M. Allen Starr, M. D., Ph. D., 
LL. D., Professor of Neurology in the College of Phy- 
sicians and Surgeons, New York; ex- President of the 
American Neurological Ass'n. Second edition, thor- 
oughly revised. Octavo, 824 pages, with 282 engrav- 
ings and 26 full-page plates. Cloth, $6.00, net; leath- 
er, #7.00, net. Lea Brothers & Co., Philadelphia & 
New York, 1907. 

We welcome with pleasure and anticipation of es- 
pecial profit to our cerebral cortex areas, the second re- 
vised edition of this much esteemed work, the first edition 



Reviews, Book Notices, Reprints, Etc. 123 



having proven a profitable contribution to our understanding 
of the subjects on which this valuable book treats. 

This book is prefaced with an interesting color show- 
ing of the relation of the neurones. 

The book being the output of the well-known medical 
publishing house of Lea Brothers & Co., of New York and 
Philadelphia, is always a guarantee of good type, press- 
work, paper and binding. 

The subject matter is arranged, illustrated and dis- 
cussed by an expert of demonstrated and approved ability 
in the medical profession. 

Besides the present work, Dr. Starr is the author of 
Familiar Forms of Nervous Disease, Brain Surgery and an 
Atlas of Nerve Cells; all well received by the profession. 

A STUDY OF THE MOTOR PHENOMENA IN CHOREA. 
By Dr. G. M. Parker, New York. Reprinted from the 
Psychological Review. 

This paper is a study of the movements observed in 
chorea. This is done with a complete awareness of the 
narrow field implied, yet with the intention of developing 
through this limited objective, certain definite, though differ- 
ent views of the pathology or psychopathology of chorea. 
The study is not one involving the basic pathological 
causes, but it is rather an analysis of its predominant man- 
ifestations, with the aim of more clearly defining the ex- 
istent physiological conditions through a psychological and 
biological interpretation of the motor phenomena. 

The author concludes the interesting subiect thus: 
"Whatever be the fundamental pathological cause of 
chorea, it is not simply a cortical irritation. The pathology 
is one which distinctly concerns the motor neurones as 
systems. That the results of the pathological process are 
not displayed as irritative neurone discharge; that rather 
analysis has shown them to be such as would result from 
the inhibition of the physiological functioning of higher 
systems, coincident with a hyperfunctioning of the 
motor neurone systems subordinate to the higher, from 
which the higher has been evolved and integrated." 



124 Reviews, Book Notices, Reprints, Etc. 



THE CHRISTIAN REGISTER, liberal in religion, strong in 
its moral and sanitary editorials, enlightening and vig- 
orous in matters of world government, its defense of 
the right and assaults upon wrong, forceful, witty and 
pure in every matter it discusses has withal, no patent 
quack or soul-polluting advertisement in its pages. 

It is a periodical fit for any hospital or asylum, where 
only pure reading matter should go to the halls or bed- 
rooms of patients. 

TEXT BOOK OF PSYCHIATRY— A Physiological Study of 
Insanity for Practitioners and Students by Dr. E. Mendel, 
A. O. Professor in the University of Berlin. Authorized 
Translation edited and enlarged by Wm. C. Krauss, 
M. D., Buffalo, N. Y., President Board of Managers, 
Buffalo State Hospital for the Insane; Medical Super- 
intendent Providence Retreat for Insane, Neurologist to 
many hospitals, etc. F. A. Davis Co., Publishers, 
Philadelphia, 1907. 

This is a very complete analysis and unique presen- 
tation of the characteristic diagnostic features of insanity 
from an experienced and authoritative source. Professor 
Mendel of the University of Boston, being well-known to 
the medical profession of the world and especially to the 
profession of the United States since 1876, when he first 
visited this country and the writer of this review had the 
pleasure of first making his acquaintance. 

This valuable book is an excellent psychological analysis 
of the salient features of insanity, a psychological study as 
the author terms it, and psychological analysis as the trans- 
lation expresses it, done by a master mind in psychiatric 
observation and practice. 

The presentation and discussion of the pathological 
disturbance in the condition of the body — "the cranium and 
so-called signs of physical degeneration — the stigmata is 
interestingly and uniquely done. The organic psychoses, 
paresis, atrophy, arterio- sclerosis and senile dementia, 
apoplexy and post apoplectic psychoses, the intoxication 
psychoses, suicide, anti-toxic, alcohol, morphine, the hys- 



Reviews, Book Notices y Retrints, Etc. 



125 



teric and epileptic and idiotic psychoses are well discussed 
and remarkably well presented for the limited space as- 
signed them. These and other features we have not space 
to present. 

These in with the treatment presented and the analysis 
of the genersl symptom etiology, the study of consciousness, 
memory, sensory feelings, associations, delusions, etc., which 
complete this valuable book, make the whole one which 
we can cordially commend to practitioners and students 
for whom the work is expressly designed and to the ana- 
lytically minded alienist and neurologist as well. 

The distinguished author, the translator and the equally 
well-known publisher have done their work well in the 
making of this commendable volume. 

"RECOLLECTIONS OF A GOLD CURE GRADUATE."— 
A grave subject humorously treated as reviewed by 
a humorous litterateur. Newton Newkirk, a Boston 
humorist, is the author of this rollicking little volume, 
with which the most sober-minded may laugh an hour 
away. It is all there, from the first round to the head- 
ache, and the illustrations by Wallace Goldsmith include 
everything from purple snakes to the tracks of the man 
who cannot believe he ever made them. Booze is not 
a nice subject, perhaps, but in the hands of a clever 
workman like Mr. Newkirk it can be a very funny one. 
The editor of The Alienist and Neurologist disclaims 
any part in the above review but he would here wish to 
remark, not upon "the purple snakes" etc., but upon "the 
tracks of the man who cannot believe he ever made them." 
Aye, there's the rub! — the psychic foot prints or rather brain 
imprints of mental deterioration and well recognized diseases 
that follow after the drunkard who does not know and can 
not yet be made to believe he could or ever did make them. 

The restored periodic, that is the inebriate recuperated 
again in his nerve centers and sound, rested and rebuilt in 
his neurones, that his brain-centers are stable and appetite 
abeyant to his enlightened will for awhile. The inebriate 
should graduate through a home and school for the imbeciles 



126 



Reviews, Book Notices, Reprints, Etc. 



and idiots, and hospitals for the insane, many of whom 
show the conjugal progeny and congenital handiwork of his 
vicious degenerating habit. Such a view would not engender 
facetious facility of description nor fondness for further 
humorous recollections, but it would certainly unfold a tale 
of hereditary alcoholic woe that ought to set any married 
or matrimonially inclined drunkard or habitual alcoholic 
beverage imbiber to serious thinking on the criminality of 
inebriety. 

THE ST. LOUIS COURIER OF MEDICINE has changed 
having gone under the control of a company of well- 
known physicians with Dr. Zahorsky as editor-in-chief. 
The January number presents all the features of a first- 
class digest of medicine. 

HISTORIC NOTES OF CANADIAN MEDICAL LORE AND 
LECTURE MEMORANDA prepared for and distributed 
to the British Medical Association by Burroughs, 
Welcome & Co., is multum in parvo mine of rare 
an.: entertaining information concerning primitive medical 
methods, early Canadian history, Indian medicine men, 
medicines, incantations, Indian' faith cures, phlebotomy, etc. 

THE NATIONAL GEOGRAPHIC MAGAZINE is a periodical 
of interest and instruction for all Americans and in fact 
for all the civilized world. It is ably edited, well- 
illustrated and strongly supported by articles of merit from 
eminently capable pens. The December number for instance 
gives the present conditions in China by Hon. John W. 
Foster, former U. S. Sec't'y of State; Latin America and 
Columbia by John Barrett, U. S. Minister there and the 
Greatest Hunt in the world, by Eliza Ruhamah Scidmore, 
Foreign Sec't'y of the National Geographical Society, author 
of Life in India. China— the long lived Empire, Janirikisha 
Days in Japan, etc. 

Gilbert H. Grosvenor and fourteen eminent collaborators 
including WJ. McGee. Director of the Public Museum of 
St. Louis, constitute the Associate Editorial Staff. 



Reviews, Book Notices, Reprints, Etc. 127 



THE HESPERIAN is a Western literary periodical of decided 
but modest, unostentatious merit, now entering 
the sixth year of its quiet, meritorious existence. 
It "lives and loves" for literature alone, its editor and pub- 
lisher. Alexander N. de Menil, being financially on easy 
street. He is known in literary circles not only because of 
his editorship of The Hesperian, but by his authorship of 
"Songs in Minority," the "Literature of Louisiana," etc. 

Published at 7th and Pine St., at 15c per copy and 50c 
per year. For sale also at St. Louis News Co. 

"THE SPECTATOR" will interest the many readers of 
the Alienist who sojourn abroad a part of each year, as 
well as our host of intelligent home readers who interest 
themselves in all matters anthropological, as well as medi- 
cal and medico- legal, in the limited sense of these latter 
terms. Moral training, and the making of patriots, the 
trust system in England, Adonis, Attis Osinis and Sabine 
(Sabian?) forms are among the matters of interest in the 
last October 7th number, besides the discussion of British 
government affairs, poetry, music, letters to the editor, re- 
views, notes on current literature, etc. 

Later numbers are equally interesting. 

CONSERVATIVE GYNECOLOGY AND ELECTRO -THERA- 
PEUTICS. — A Practical Treatise on the Diseases of 
Women and their Treatment by Electricity. By G. 
Betton Massey, M. D., Attending Surgeon to the 
American Oncologic Hospital, Philadelphia; Fellow and 
ex-President of the American Electro-Therapeutic 
Association, etc., etc. Fifth, Carefully Revised Edition. 
Illustrated with Twelve (12) Original Full-page 
Chromo-lithographic Plates of Drawings and Paintings, 
Fifteen (15) Full-page Half-tone Plates of Photo- 
graphs made from Nature, and 157 Half-tone and 
Photo-engravings in the text. Complete in one Royal 
Octavo Volume of 467 pages. Extra Cloth and 
Beveled Edges. Price, S4.00 net. F. A. Davis Com- 
pany, Publishers, 1914-16 Cherry Street. Philadelphia. 



128 



Reviews, Book Notices, Reprints, Etc. 



We can not now, as we reach the close of the Feb- 
uary number of the Alienist and Neurologist go over the 
entire scope of this valuable volume. The well-known 
repute of the author in electrotherapy, general and special, 
his fame in the electro-therapeutics of gynecology, our familiar- 
ity with the preceding editions and comparative examination of 
the present justify commendation of the present book to those 
seeking a practical treatise of the special diseases of women 
and their treatment by electricity. The author's notes on 
neurasthenia, pp. 91, et seq., on portable batteries, pp. 245, 
et seq., his discussion and illustrations on the Roentgen 
rays, fluroscopy, the handling of currents, electrodes, dos- 
age, resistance, etc., the neuroses of urethra and vulva, 
sterility, impotence, carcinoma, ovaritis, congestion, senile 
uteritis will all, as heretofore, interest and hold the atten- 
tion of the broadly intelligent class of readers who count 
the Alienist and Neurologist among their regular magazines. 

AN ILLUSTRATED ANNOUNCEMENT of "Beverly Farm," 
Private Home and School for nervous and backward 
children, conducted by W. H. C. Smith, M. D.. Super- 
tendent, at Godfrey, Madison County, Illinois, comes to 
us, showing continued prosperity and well-merited sup- 
port. 

Dr. Smith was in charge of the Collective Exhibit of 
the Association of American Institutions for the Feeble 
Minded, located in Section 5 of the Social Economy Divis- 
ion, in the Education Building at the World's Fair, and was 
awarded a Grand Prize, Diploma and Medal as a 
collaborator of this Exhibit by the Grand Jury of the 
Louisiana Purchase Exposition. 

"HUMANITY," which comes irregularly to our sanctum, is 
a collection of short and interesting stories and dis- 
sertations of merit and well illustrated. Its motto, 

"humanity covers the whole field," is illustrated on the 

front cover in colors which a bill poster is about to paste 

on the wall. 

An article in the October number, entitled "For Profes- 



Reviews, Book Notices, Reprints, Etc. 



129 



sional Services, The fine art of graft among physicians" may 
possibly apply to some among a certain society pandering 
criminal class, but does not describe any set of physicians or 
surgeons with which the editor of this Journal is familiar. 
There may be such as these, as sandbaggers, confidence 
swindlers, thieves and murderers among men in other walks of 
life, but we have not encountered them among our fellows 
of the regular medical profession. The writer of the article 
is Richard Jones. He admits that data for his statements 
of medical villainy and deceit "is" (are "of course") "almost 
wholly unprocurable" and his concluding paragraphs, 
conceding that there exist instances of "isolated God- 
inspired cases of eminent specialists and respectable family 
physicians," that "there are in a hundred other instances 
partners in a scheme for graft" — a sure thing game from 
start to finish because "it (the profession trades in mystery 
and threatens death)" suggests the old court reproof l "honi 
soit qui mal y pense" and one wonders what sort of crafty 
quack such a writer might have made, had humanity been 
cursed with him as a member of the medical profession 
to hishonor the calling and disgrace the noble name of 
honest humanity. 

The review department, after giving well -merited notes 
of commendation to the Boer War, General Vilioens' inter- 
esting book and "Hawaii and Yesterday" by Henry J. 
Lyman, who as the son of a missionary among the 
Hawaiians, speaks thus of " Enigmas of Psychical ResearcJi," 
by Prof. James H. Hyslop. "Probably n© subject is attracting 
more attention in the religious and scientific sphere of 
activity than the truths which are being explained as a 
result of psychical research. 

"The objection that can be put forward regarding nearly 
all works on the subject, u e., they are filled with bad 
reasoning and forced conclusions because of the over- 
anxiety of the authors in this field, will not apply to Prof. 
Hyslop's work, as he rarely attempts to draw any conclu- 
sions from the facts that he brings out and when he does 
it is with great caution that his conclusions are thoroughly 



130 Reviews, Book Notices, Reprints, Etc. 



founded upon good reasoning. His principal idea in the 
work is not so much to show what has been done in this 
line as it is to show the virtue and value of the study of 
Psychological Phenomena." 

Save for the one article unjust to the medical profes- 
sion, which we have criticized, the magazine will please you. 
Its price is ten cents per copy. 

NERVOUS AND MENTAL DISEASES. By Archibald Church, 
M. D., Professor of Nervous and Mental Diseases and 
Medical Jurisprudence in Northwestern University Med- 
ical School, Chicago; and Frederick Peterson, M. D., 
President of the State Commission in Lunacy, New 
York; Clinical Professor of Neurology and Psychiatry, 
Columbia University. Fifth edition, revised and enlarged. 
Octavo volume of 937 pages, with 341 illustrations. 
Philadelphia and London. W. B. Saunders & Company, 
1905. Cloth, $5.00 net; Half Morocco, $6.00 net. 
We can only reiterate the former favorably expressed 
opinion of this valuable contribution to the literature which 
is, in each succeeding edition, revised up-to-date. Its 
authors men who keep themselves abreast of neurologic, 
neuriatric, psychologic and psychiatric advance. This book 
is worthy of a prominent, accessible place in any medical 
library. 

Report of the Department of Health of the Isthmian 
Canal Commission for the month of October, 1906. W. 
C. Gorgas, U. S. A. Chief Sanitary Officer. 

The Growing Years. By William Seaman Bainbridge, 
A. M., M. D., New York. 

A Brief Resume of the World's Recent Cancer Re- 
search. By William Seaman Bainbridge, M. D., New York. 

Mysophobia, with Report of Case. By John Punton, 
M. D., Kansas City, Mo. Professor of Nervous and Mental 
Diseases, University Medical College, etc. 

Was Percival Pott Really Entitled to the Honor of 
Having a Certain Spinal Disease Called by His Name? By 
A. J. Steele, M. D., St. Louis. 



Subscription Bargains. 



offer the following - special inducements to new subscribers to the 
Alienist and Neurologist for [907. 



Regular Subscriptions: 

?nist & Neurologist $5.00 I R CA 

r r) ' *% aa i Both one year, $5.50 

/lew of Reviews 3.00 ) 



?nist & Neurologist $5.00 t u . u AA 

i aa i Both one year, $5.00 

:cess 1.00 ) 

mist & Neurologist $5.00 I « 4U AA 

, u ~ & , AA } Both one year, $5.00 

man s Home Companion 1.00 1 

*nist & Neurologist $5.00 . 

iew of Reviews 3.00 [ Three one year, $6.00 

cess 1.00 > 

nist & Neurologist $5.00 . 

iew of Reviews 3.00 [ Three one year, $6.00 

man's Home Companion 1.00 J 

nist & Neurologist $5.00 ] 

cess 1.00 > Three one year, $5.50 

man's Home Companion 1.00 J 



Address 



H. L. HUGHES, 

2 Washington Boulevard, ff ST. LOUIS, MO. 



ITS COVER PORTRAITS 

have made it famous 



AGE: TWENTY-FIVE YEARS 

— and still growing! 



7246 



PROGRESSIVE 
PHYSICIANS 



READ THE 
MEDICAL 
HERA L D 



OFFICIAL JOURNAL 
MEDICAL SOCIETY 
OF MISSOURI VALLEY 



YOU 



MAY BECOME ONE 
OF THIS CLASS FOR 
ONE DOLLAR . . . 



Clean, Ethical, Newsy, Original. Un- 
trammelled by trade connections — unbiased 
in its utterances — and broad enough to re- 
nounce illogical traditions and narrow 

dogmas . 



Its Original Department reflects 
the progress of the stalwart Prac= 
titioners of the great Middle West. 



The Oldest Independent 
Medical Monthly 
west of the 
Mississippi River 



EDITED AND PUB- 
LISHED BY MEDICAL 
MEN: ITS AIM TO AD- 
VANCE THE CAUSE OF 
SCIENTIFIC MEDICINE 



CIRCULATES 
IN A FIELD 
PECULIARLY 
ITS OWN 



$1.00 the year 



For specimen copy, premium list and schedule for game "500" address 

DR. CHAS. WOOD FASSETT, 

Managing Editor. ST. JOSEPH. MO. 



Reviews, Book Notices, Reprints, Etc. 131 



And Dr. Steel, after citing Percival Potts' well-known 
description and interestingly giving somewhat of Dr. Potts' 
biography, answers that "he was." This brochure is de- 
serving of a place in every medical man's library. Copies 
of the discoverer's original illustrations and an engraving of 
Percival Potts, from a painting by Reynolds, accompany 
this valuable monograph. 

Presidential Address. The Physician as a Character 
in Fiction. By C. B. Burr, M. D., Medical Director Oak 
Grove, Flint, Mich. 

The Bulletin of the University of Nebraska College of 
Medicine. Contents: I. The Microscope in its Relation to 
Medicine. By James Carroll, Washington, D. C. 11. A 
Study of Filtration in the Lung of the Frog. By A. E. 
Guenther and R. A. Lyman, Lincoln, Neb. 

Report of Five More Apparent Cures of Pulmonary 
Tuberculosis Occurring in Working People, who were 
Treated at a Dispensary Without Interruption to their 
Work. By John F. Russell, M. D., New York. 

Principles of Spelling Reform. By F. Sturges Allen, 
New York. 

Clinical Psychology. By Frank Parsons Norbury, A. 
M., M. D. Jacksonville, 111. 

An excellent and timely contribution to the subject, es- 
pecially appropriate to be imparted to a general medical 
society. The profession needs, and is sensibly seeking, 
more light on this important subject, in the general 
practice of medicine from sources of right clinical experi- 
ence, a source from which this communication comes. 

Second Biennial Report of the Parsons State Hospital 
for Epileptics, Parsons, Kansas. 

A Clinical Lecture on Malignant and Non-Malignant 
Growths. By Wm. Seaman Bainbridge, A. M., M. D., New 
York. 




The Ralph 
Sanitariui 



for the Treatment of 

Alcoholism and 
Drug Addiction 

THE method of treatment 
new and very successful, ' 
withdrawal of the drug is 
attended by any suffering, and 
cure is c omplete in a few we 
time. The treatment is varied 
cording to the requirements 
each individual case, and the 
toration to normal conditiot 
Hastened by the use of electric 
massage, electric light baths, 
and cold tub and shower ba 
vibratory massage, and a libe 
well-cooked, digestible diet. 

modern, carefully conducted home sanitarium, with spacious surroundings, and attractive dr 
and walks. Electro- and Hydro-therapeutic advantages are unexcelled. Trained nurses, hot w: 
heat, electric lights. Special rates to physicians. For reprints from Medical Journals and full de 
of treatment, address 

DR. B. B. RALPH 5Z \Xr d Kansas City, M 



MARI 





THE MAN 
WHO KNOW, 

goes after deer and all big game 
Marlin. He backs his own ski 
Marlin accuracy. 

Marlin Repeaters have origin 
tures shown by no other make 
hoot truer, stand harder service « 
absolutely dependable. 

The Model 1893 Marlins have " 
Smokeless Steel" Barrels using p» 
smokeless loads. The .32-40 and 
sizes are also made with the highe; 
of soft steel barrels for black j 
The .30-30, .32-40 and .38-55 rt 
are the guns for deer and simila 
The Men Who Know have to 
of good Marlin stories in our Exr 
Book — Free — with our catalogi 
best so far) for 3 stamps postag 

THE MARLIN FIREARM.! 

Willow St. f New Haven,* 



PUBLISHER'S DEPARTMENT. 



THE SOUTHWEST MISSOURI IDEA OF MEDICAL PRAC- 
TICE STATE REGULATION.— At a special meeting of the 
Gasconade-Maries- Osage Counties Medical Association at 
Bland, Mo., December last, the following appended resolu- 
tions adopted for the consideration of the Missouri State 
Legislature, were adopted: 

"We favor just and honorable medical legislation, to 
the end that all citizens be protected against incompetent 
pretenders, and that our laws be so amended that honest, 
industrious aspirants, with a fair education and good moral 
character, though with limited means, be enabled to enter 
the profession after due preparation. 

"We believe that in the past medical students have 
been compelled to carry the financial burden of the Mis- 
souri state board of health by being compelled to pay an 
examination fee of $15.00 for an examination and license to 
practice, which we consider unjust, inasmuch as this class 
is not well prepared to carry this burden. 

"We believe that there should be created a state 
health office, presided over by a state health commissioner, 
and that in all matters of public health he have juris- 
diction; that the law should be so changed that the cor- 
oner of each county should be the county health officer; 
that the state health commissioner and the county coroner 
have cojurisdiction in all matters of public health and san- 
itation, and that these officers supplant the present state 
and county boards of health. 

"We believe that the law should be so changed as to 
provide for a state examining board,* appointed by the 
governor, who should examine and license applicants to 
practice medicine, surgery and midwifery in the state. 



♦Independent of the State Board of Health. 

( 132 ) 




A new book, Diet after Weani 

We have issued this book in response to a constantly inc 
ing demand for suggestions on the feeding and care of the 
between the ages of one and two years. 

We believe you will find it a useful book to put in the h 
of the young mother. 

The book is handsomely printed, fully illustrated ai 
bound in cloth. We shall be glad to furnish you copie 
patients entirely free. 

A postal card with your name and address on k will 1 
you a copy by return mail. 



MELLIN'S FOOD COMPANY, 



BOSTON, M 



Publisher's Department. 



133 



"We favor the taking and recording of vital and mort- 
uary statistics, and we favor that the law be so amended 
that these statistics be taken by the county assessor at the 
time he is listing the taxable wealth of the county. 

"We favor that the time for the commencement of mal- 
practice suits should be reduced from five to one year, and 
that all malpractice suits should be barred by the statutes 
of limitation after expiration of one year." 

THE NOBEL PRIZE AWARDS.— The Nobel Prize in 
Medicine was divided between Prof. Golgi, of the Pavia 
University, and Prof. Ramon y Cajal, of Madrid. Prof. 
Moissan, of Pans, received the chemistry prize for his ex- 
periments in the isolation of fluorine and his researches in- 
to its nature, also for his application of the electric furnace 
to scientific uses. Prof. Thompson, of Cambridge Univer- 
sity, received the physics prize for his researches into the 
nature of electricity. The King of Sweden formally pre- 
sented the prizes and medals on December 10th. 

MALARIAL CACHEXIA.— The cachexia resulting from 
malaria is often persistent, even after the active cause has 
been controlled. In such cases, Gray's Glycerine Tonic 
Compound proves of great service in stimulating the re- 
constructive powers of the blood. The toxins resulting 
from the malarial hemolysis are rapidly eliminated, and in- 
creased impetus is given to the restoration of normal red 
blood cells. 

OUR CONFIDENTIAL FRIENDS.— We would not ban- 
ish opium. Far from it. There are times when it becomes 
our refuge. But we would restrict it to its proper sphere. 
In the acute stage of most inflammations, and in the clos- 
ing painful phases of some few chronic disorders, opium in 
galenic or alKaloidal derivatives, is our grandest remedy — 
our confidential friend. It is here also that the compound 
coal-tar products step in to claim their share in the domain 
of therapy. Among the latter, perhaps, none has met with so 
grateful a reception as "Antikamnia and Codeine Tablets," 



WE SUPPLIED ALL THE CITY INSTITUTIONS WITH DRY GOODS LAST YEAR. 

WM. BARR GOODS 

cc 

Keep the Largest Stock of Goods suitable for 

HOSPITAL PURPOSES I 

TO BE FOUND IN ST. LOUIS, 

And Special Terms will be made with all Institutions ordering from them. 

BEDDING MATERIALS OF ALL KINDS, 

UNDERCLOTHING, IN SILK, WOOL AND COTTON, 

LADIES' AND CHILDRENS 1 READY-MADE CLOTHI} 
FLANNELS AND UPHOLSTERY, 

TABLE AND BED ROOM LINENS, 

SOAPS, NOTIONS AND PERFUMER! 
ARE ALL SPECIALTIES AX THE; 



WM. BARR 



DRY 
GOODS 



GO'S! 



NEW BUILDING, 
SIXTH, OLIVE AND LOCUST, 

P. S. Write and find out our special terms to Hospitals. 



ST. LOl 



HALL- BROOKE 

A Licensed Private Hos- 
pital for Mental and 
Nervous Diseases. 



CASES OF ALCOHOLISM 
AND DRUG HABIT. 



jDEAUTIFULLY situated on Long 
*-* Island Sound one hour from New 
York. The Grounds consisting of over 
ioo acres laid out in walks and drives 
are inviting and retired. The houses are 
equipped with every Modern Appli- 
ance for the treatment and comfort of 
their guests. Patients received from 
any location. Terms Moderate. 

DR. D. W. McFARLAND, 
GREEN'S FARMS, 
CONN. 

Telephone 67-5, Westport, Conn. 



THE NATIONAL MEDICAL EXCHANGE— Physicians', De 
1 and Druggists' Locations and Property bought, 
rented and exchanged. Partnerships am 
Assistants and substitutes provided. Bu 
strictly confidential. Medical, pharmaceutica 
scientific books supplied at lowest rates. Sei 
cents tor Monthly Bulletin containing 
locations, and list of books. All inquiries pre 
answered. 
Address, 

H. A. MUMAW, M. D. Elkhart, lnd. 



THE NATIONAL 

Surgical and Dental Chair Exchan 

All kinds of new and second 
Chairs, Bought, Sold and Exchanged. 

m~sm FOR OUR BARGAIN list-* 

Address with stamp, 

Dr. H. A. MUMAW, Elkhart, lnd 



LARGE DIVIDENDS 

Are assured stockholders of the SIE! 
PACIFIC SMELTING CO., Sonora, 
Mexico. 

Easy Payments. Agents Wantec 
Write for terms. 

Address, 

HENRY MUMAW, Elkhart, I 



Publisher's Department . 



134 



and justly so. Given a frontal, temporal, vertical or occipi- 
tal neuralgia, they will almost invariably arrest the head- 
pain. In the terrific fronto-parietal neuralgia of glaucoma, 
or in rheumatic or post-operative iritis, they are of signal 
service, contributing much to the comfort of the patient. 
Their range of application is wide. They are of positive 
value in certain forms of dysmenorrhoea ; they have served 
well in the pleuritic pains of advancing pneumonia and in 
the arthralgias of acute rheumatism. They have been found 
to allay the lightning, lancinating pains of locomotor 
ataxia, but nowhere may they be employed with such con- 
fidence as in the neuralgias limited to the distribution of 
the fifth nerve. Here their action is almost specific, sur- 
passing even the effect of aconite over this nerve. 

"OUR READERS will note from the New Antikamnia 
advertisement which appears in this issue, that the Anti- 
kamnia Chemical Co., was prompt to file its Guaranty un- 
der the New Pure Food and Drugs Act, their Guaranty 
number being 10; which means that of all the Food and 
Drug Manufacturers in the United States, only nine filed 
their Guaranty in Washington before that of the Antikam- 
nia Chemical Company. 

This shows the usual Antikamnia disposition to pro- 
tect the dealer and prescriber of Antikamnia under the law 
and gives assurance of the absolute reliability of the Anti- 
kamnia preparations." 

AS THE COLDER WEATHER APPROACHES, certain 
diseases and remedies will be more on the mind of the 
profession. Among the remedies will be cod liver oil. 
Hagee's cordial of the extract of cod liver oil compound is 
not only one of the most popular cod liver oil preparations 
on the market, but one of the very best if not, indeed, the 
best itself. All the nutritive properties of the oil are re- 
tained and the disgusting and nauseating elements are 
eliminated. Combined with hypophosphites of lime and 
soda, it offers to the profession a reconstructive of great 
value. The writer has for some years prescribed it freely, 
and with great satisfaction. — Massachusetts Medical Journal. 



The Perfect Food Digestor 

FORBES DIASTASk 



will digest a far greater quantity of starch food and thus through t 
formation of dextrines, both albuminoids and fats than any prodt 
extant; acting in acid, alkaline or neutral media. 

Giving perfect Digestion, Assimilation, Metabolism and Nutrition 



DOSE: ONE TEA SPO ONFUL 



A Palatable Concentrated Solution of Diastase from Malt without 

sugar. 



A large bottle (or several if requested) will be delivered free f 

clinical trial. 

THE FORBES DIASTASE CO. Marietta, Ohit 



Impotency Cases 



It matters not how hopeless; cured or relieved by our combination. 

Helantha Compound. 

Helianthus annuus [sunflower.] Fr. root, bark.H. Australian. Plain 
or with diuretic. 

Has a powerful action upon the blood and entire organism is in- 
dicated in all cases complicated with Malaria, Scrofula, im- 
poverished Blood, Anaemia, etc.. etc., in conjunction with Pil Orient- 
alis (Thompson), will control the most obstinate cases of Impo- 
tency. "Drink Cure" cases, saturated with Strychnine, "Weak 
Men" cases, who tried all the advertised "cures" for impotency, 
and were poisoned with Phosphorus compounds readily yield to 
this treatment. Pil Orientalis (Thompson) contains the Extract 
Ambrosia Orientalis. 

The Therapeutical value of this Extract as a powerful Nerve 
and Brain tonic, and powerful stimulant of the Repro- 
ductive Organs in both Sexes, cannot be over-esti- 
mated. It is not an irritant to the organs of generation, but A 
RECUPERATOR and supporter, and has been known to the native 
Priests of India, Burmah and Ceylon for ages, and has been a harem 
secret in all countries where the Islam has planted the standard of 
Polygamy. 

It is impossible to send free samples to exhibit in Impotency 
cases, requiring several weeks treatment, but we are always willing 
to send complimentary packages of each preparation (with formulas 
and medical testimonials) to physicians who are not acquainted 
with their merits. 

p . f Helantha Compound, $1.85 per oz. Powder or Capsules, 
rnces. | pj , Orientalis(Thompson)$1.00 per box. 



THE IMMUNE TABLET COMPANY, 



WASHINGTON, 
D. C. 
AGENTS: 

Meyer Bros. Drug Co., St. Louis. 
Lord, Owen & Co., Chicago. 
Evans-Smith Drug Co., Kansas City. 
Redlngton & Co., San Francisco. 
J. L. Lyons & Co., New Orleans. 



mm 



ENGRAVIN( 
CO. 

MEANS -THAT YOU 
CAN GET HIGH GRADE 
CUTS FOR ANY KIND 
OF LETTER PRESS 

PRINTING AT 

8 4 MASON ST 
M I LWA U KEE 



HALFTONES ON ZINC OR COPPI 
WOOD ENGRAVING W&Sc^M 
ORIGINAL DESIGNERS & ART IS 



Publishers Department. 



135 



DR. F. E. DANIEL, of Austin, Texas, in his presi- 
dential address before the last Tuberculosis Congress, at 
New York, among other pertinent things, said: 

"The keynote of the convention is to be 'the pre- 
vention or tuberculosis by legislation.' The Government 
succeeds from time to time in eradicating yellow fever and 
cholera. Why not consumption, which causes ore-seventh 
of our deaths? 

"Unnatural living in cities is a productive cause. 
Whiskey and consumption follow the flag and the Bible in 
the march of civilization. Churches are veritable 'black 
holes of Calcutta.' 1 attended a church where, according 
to my calculation, the same air was breathed and re- 
breathed by each of the 500 members of the congregation 
every twelve minutes, or twelve times in the course of the 
service." 

The medical profession has done its part well in re- 
vealing and warning against this deadly, but conquerable 
foe of health and life; now let the people profit by our 
admonition and enforce strenuous legal measures, the elimina- 
tion of this menace against health and life, from among 
the people. The indifferent disseminations of this dis- 
ease must be made different, the unconcerned brutes that 
expectorate when they ought not, should be treated like 
those who would defecate or urinate in improper public 
places. The street car and register spitter and the dirty 
expectorator in decent places should be restrained within 
bounds of propriety, or exterminated from public places, 
street car conductors, motormen, policemen and hotel em- 
ployes and church janitors, and all who use heat registers, 
stoves, etc,, included. 

AN EFFICIENT MEANS OF RELIEVING PAIN.— The 
pain which accompanies the intestinal diseases resulting 
from grippe colds is often severe and requires the use of 
an effective anodyne. Papine is peculiarly adapted to such 
needs, as it represents all of the pain relieving properties 
of opium without its narcotic and nauseating effects. It is 
apparent that such a remedy has a wide range of useful- 



CACTINA 

PILLETS 



A Cardiac Tonic 
Stimulant 



From Cereus Grandiflora(Mexicana) 

Each PUIef containing One One- 
Hundredth of a grain of Cactina 

Indicated in functional cardiac 
troubles, such as tachycardia, palpi- 
tation, feebleness; and to sustain the 
heart in chronic and febrile diseases* 
It is not cumulative in its action. 

DOSE— One to three Piliets 
three or four times a day. 
Put up is bottles of 100 piilets 

Free samples to PHyslcisrrs upon request 



Sultan Drug Co., St. Louis, Mo. 

Pharmaceutical Chemists 



SENC 

A Digestive 
Secernent 

A preparation of Panax (Ginsec 
which is being successfully ei 
ployed to stimulate the secrete 
glands of the alimentary canal. 
Indicated in Indigestion. Malnut 
tion, and all conditions arising frc 
a lack of digestive fluids. 

DOSE One or two teaspooofuls 
three or more times a day 

POT UP IN 10 OZ. BOTTLES OKI 

Free samples to Physicians upon request 



Sultan Drug Co,, St. Louis, IV 

Pharmaceutical Chemists 



PEACOCK'S 
BROMIDES 



THE BEST FORM 
OF BROMIDES 



Each fluid drachm contains 15 grains 
of the neutral and pure bromides of 
Potassium, Sodium, Ammonium, Cal- 
cium and Lithium. 

In Epilepsy and all cases demanding 
continued bromide treatment, its 
purity, uniformity and definite thera- 
peutic action, insures the maximum 
bromide results with the minimum 
danger of bromism or nausea. 

DOSE One to three teaspoonfuls ac- 
cording to the amount of Bromides 
desired. Put up in 1-2 pound bot- 
tles only. Free samples to the 
profession upon request 



Peacock Chemical Co., St. Louis, Mo. 

Pharmaceutical Chemists. 



CHIONI/ 



The Hepatic 
Stimulant 



Prepared from Chionanthus Virgin 
Expressly for Physicians* Prescript*! 



Chionia is a gentle but certain sti 
ulant to the hepatic functions «j 
overcomes suppressed biliary sec 
tions. It is particularly indicated 
the treatment of Biliousness, Jai 
dice, Constipation and all conditi* 
caused by hepatic torpor. 

DOSE- One to two teaspoon' 
fuls three times a day. Pat 
up in 1-2 pound bottles only 

Tree samples to Physicians upon request 



Peacock Chemical Co., St. Louis, ft 

Pharmao< uttcat Chemists. 



Publisher's Department . 



136 



ness, and that Papine is well appreciated by the medical 
profession, is shown by the place it has occupied in the 
medical armamentarium for so many years. — The International 
Journal of Surgery. 

THE POETRY OF MEDICAL MEN. — That medical men 
are not devoid of sentiment and wit, we have from time to 
time given samples in these pages. The following is our 
friend of the Medical Review, Kenneth W. Millican's 
Christmas and New Year's greeting to his friends: 

A CHRISTMAS SONNET. 

Christmas once more! How the swift years glide by! 

Bring in the blazing Yule log. Close the door 
And draw the curtains on the chill blast's roar 

And warring elements. Light up, and vie, 
Y r oung folks and old, in Christmas revelry. 

Games, stories, dancing when the feasting's o'er, 
(But crafty mistletoe thrills young maidens more). 

Attune all hearts to mirth and jollity. 

Yet not alone at home, but in the soul, 

Kindle the glowing fire of kindliness. 

Shut out the chilling blasts of self, the stress 
Of worldly strife, and then, to crown the whole 

A merry Christmas and a glad New Year, 
Light up the mind with helpful rays of cheer. 

K. W. M. 

DYING OF A ROSE IN AROMATIC PAIN came near 
being the fate, according to the exuberant imagination of a 
newspaper reporter, of some of the lady customers in a 
New York drug store December last. 

A three-hundred bottle full of perfumery exploded in 
the show window of a Park Row drug store with a loud 
report and scattered broken glass all over the store. The 
odor almost overcame the clerks and a number of shoppers. 

No one was struck by the flying fragments. Fifty 
customers in the store, most of them women, were too 
frightened to move. The perfume was highly concentrated 
and almost suffocated everyone. The manager hastily 
opened the doors and windows, allowing the scent to mingle 



River Crest Sanitarium SSaJSJ 

Astoaia. L. I.. Xew York City. in Lunacy.^ 

FOR NERVOUS AM) MENTAL DISEASES. 

Home-like private retreat. Beautifully located. Easily accessible. 

Detached buildingjfor alcoholic and drug habit 
Hydrotherapy. Electricity. Massage. 

J. JOS. KINDRED. M. D.. WM. E. DOLD. M. D.. 

President. Phvsician in Cha 



Xew York office 616 Madison are., cor. 59th St.; hours, 3 to 4 and by appointm 
Phone. 1470 Plaza. Sanitarium Phone, 36 Astoria. 



The Richard Gundry Home, 

CATONSVILLE, BALTIMORE CO., MD. 

A private Home for the treatment of Mental and Nervous Diseases. Opium and A 
holic addictions. For Circulars, Rates, etc.. Address. 

DR. RICHARD F. GRUNDY. Catonsville, Md 

References — Dr. Henry M. Hurd. Dr. Wm. Osier. Johns Hopkins Hospital. Baltim 
Md. Dr Thomas A. Ashby. Dr. Francis T. Miles and Dr. Geo. Preston, Baltimore, 
Dr. George H. Rohe. Sykesville. Md. Dr. Charles H. Hughes, St. Louis. 



THE BLUE HILLS SANITARIUM M;LTON MASSACHUSETTS. 

A PRIVATE HOSPITAL AND IDEAL RESORT. 

All classes of patients admitted. Separate department for the victims of 
ALCOHOL. OPIUM. COCAINE AND OTHER DRUG HABITS. 

All desire for liquors or the baneful drugs overcome within three days after entra 
and without hardship or suffering. 

A well-equipped Gymnasium, with competent Instructors and Masseurs, for the administration of P 
hygienic treatment: also a Ten-plate Static Electrical Machine, with X-Ray, and! all the various attachnei 

J. FRANK PERRY. M. D.. Supt. 



THE ALPHA SANITARIUM, 

LAKE FOREST, ILLS. 

Established for the treatment of the Functional Derangements and Moi 
Psychologies that occur during Adolescence. 
For further particulars address 

W. XAVIER SUDDUTH, M. D., 100 State St., CHICAC 



Publisher's Department . 



137 



with the odors of Park Row, which had a diluting and 
neutralizing effect. 

1COCA A TRUE HEART TONIC— (1) Coca is a depur- 
ative of the blood stream, favoring the elimination of the 
products of tissue waste. 

(2) Coca renders the muscular structure of the heart 
free to perform its functions untrammeled by a clogging of 
waste products in the blood which would otherwise impede 
function both mechanically and chemically. 

(3) Coca acts directly on the cardiac muscle. 

(4) Coca is a tonic to the vaso-motor nerves. 

(5) Coca is a stimulant to the vagus centre. 

The value of Coca as a heart tonic should not be lost 
sight of. Unlike digitalis, Coca does not upset the stomach, 
is not cumulative, does not abnormally slow the pulse nor 
injure the heart muscle. It is not injurious or harmful in 
any way. Coca is useful in disease of the cardiac valves 
or of the heart muscle itself, as well as in allied troubles 
of the organs of respiration and of the kidnevs. In mere 
cardiac weakness, whether from emotional irritation, infec- 
tious disease or overstrain, it is an invaluable remedy; 
and unlike digitalis, it is particularly serviceable when the 
cardiac nerves are at fault. Besides Vin Mariani, the form 
advocated is the concentrated fluid extract, Mariani Tea, of 
which a drachm or two should be given at a dose about 
every three or four hours. When cardiac tonics are indi- 
cated enforced rest and a regulated dietary should be 
preliminary to all forms of treatment. — The Coca Leaf, Way, 
1905. 



The MILWAUKEE SANITARIU1 

Wauwatosa, Wis. 
FOR NERVOUS AND MENTAL DISEASES 

Wauwatosa is a suburb of Milwaukee on the Chicago, Milwaukee and St. Paul F 
way, 2% hours from Chicago, 5 minutes' walk from all cars and trains. 

Physician in charge: RICHARD DEWEY, A.M., M.D. 

CHICAGO OFFICE, 34 Washington St., Wednesdays 2 to 4 P. M., (except in 
and August). 

Telephone connections, Chicago and Milwaukee. 



Gteenmont-on-the-Hudson. 

For NERVOUS and MENTAL DISEASE 
RALPH LYMANS PARSONS, M.D. RALPH WAIT PARSONS, M.D. 



City Office, 21 East 44th St., 
Mondays and Fridays, 3:30 to 4:30, p.m. 



SING SING, P. O. , N- Y. 
Long Distance Tel. , Hart, 140A, Sing Sing, 



CREST VIEW SANITARIUM, 

GREENWICH, CONN. 

A quiet refined home for the treatment of 

Chronic and Nervous Diseases. 

In the midst of beautiful scenery, 28 miles from New 1 

H. M. HITCHCOCK, M. D 



EUGENE : Given Free 

field's! 

POEMS* 
A $7.00 



t to each person interested in 2 

subscribing to the Eugene * 

Field Monument Souvenir i 

Fund. Subscribe any amount t 

desired. Subscriptions as low J 

as $1.00 will entitle donor to 2 

his daintily artistic volume X 



Field Flowers" 

(cloth bound, 8x11), as a 
certificate of subscription to 
fund. Book contains a selec- 
■m g± f± mm Z tion of Field's best and most 

III f representative works and is 

U \J |\ t ready for delivery. 

But for the noble contri- 
bution of the world's greatest 
artists this book could not 
have been manufactured for 
less than $7.00. 

The Fund created ^ 
vidsd equally between the family of the late Eugene Field 5 
and the Fund for the building of a monument to th* mem- ; 
ory of the beloved poet of childhood. Address 
EUGENE FIELD MONUMENT SOUVENIR FUND, 
(Also at Bcok Stores) IQ4 Clinton St., Chicago 
If y^u also wish to send postage, enclose 10 cts. 



THE Book of the century 
Handsomely Illus- 
trated by thirty- 
two of the World's 
Greatest Artists. 



1 for 5 

is di- ♦ 
;ld I 
m- t 

>.i 
! 



Pfll K'^ MEDICAL REGIS! 

I ULI\ O AND DIRECT 



WAS ESTABLISHED IN 1886. 



Do Not Be Deceived By Imitators 

See that the name K. L r POLK A 

IS ON THE ORDER BEFORE Y( 
SIGN IT 

POLiK'S is the only complete Medical Direc 
1*0 lilt'S is the only Medical Directory havi 

index to all physicians in the United Stat 
POLK'S has stood the crucial test of time 

increasing popularity. It thoroughly c 

the field, 

P 



R. L. POLK & CO., Publish 



si its< it 1 it 1. sow 



This is the Best Medium 
for 

— Sanitaria — 



.1 



THE 

ALIENIST AND NEUROLOGIST. 



VOL. XXVIII. ST. LOUIS, MAY, 1907. No. 2. 

IS GENIUS A SPORT, A NEUROSIS, OR A CHILD 
POTENTIALITY DEVELOPED? 



By JAS. G. KlERNAN, M. D., 

CHICAGO. 

Fellow of the Chicago Academy of Medicine; Foreign Associate 
Member French Medico-Psychological Association; Hon- 
orary President Section of Nervous and Mental Dis- 
eases, Pan American Medical Congress, 1893; Pro- 
fessor of Medical Jurisprudence, Dearborn 
Medical College; Professor of Foren- 
sic Psychiatry, Kent-Chicago 
College of Law. 

THE doctrine that genius* is abnormal, is an old one, 
probably originating when Shamans preceded their 
vaticinations by self-induced convulsions and trances. 
These are much more frequent in primitive man and even 
in man at the culture level of the Mahommedan countries. 
They occur wherever emotionalism and religiosity domi- 
nate religious gatherings. They were a familiar feature of 
the Kentucky and Tennessee revivals of the early 19th 
century. They crop up now in sects where religious emo- 
tional intoxication is a part of the cult. This genius 
folklore influenced the Greek philosophers. Indeed, Plato 
plainly claims a shamanistic origin. "Delirium," he re- 

* Alienist and Neurologist, 1887-1891. 

( 139 ) 



140 



J as. G. Kiernan. 



marks, "is by no means evil, but when it comes by the 
gift of the gods, a very great benefit. In delirium the sybils 
of Delphi and Dodona were of great service to Greece, but 
when in cold blood, were of little or no service. Frequently, 
when the gods afflicted men with epidemics, a sacred de- 
lirium inspired some men with a remedy for these. The 
Muses excite some souls to delirium to glorify with 
poetry heroes or to instruct future generations." 

"Under the influence of head congestion," remarks 
Aristotle, "persons sometimes becomes prophets, sybils and 
poets. Thus, Mark, the Syracusan, was a pretty fair poet 
during a maniacal attack, but could not compose when sane. 
Men, illustrious in poetry, arts and statesmanship, are often 
insane, like Ajax, or misanthropic, like Bellerophon. Even 
in a recent epoch similar dispositions are evident in Plato, 
Socrates, Empedocles and many others; above all, the 
poets." 

The shamanistic phenomena so closely resembled epi- 
leptic in their frenzies and visions that the two states 
were long regarded as identical, whence the term "morbus 
sacer." This sacred notion of epilepsy was so dominant 
in the time of Hippocrates* that he found it necessary to 
confute it so as to reduce epilepsy to its modern nosologic 
status. His argument points out that epilepsy is heredi- 
tary, and is due also to traumatism and the other causes 
which are today regarded as producing it. The sacred con- 
ception of madness and epilepsy partook of the capricious 
nature of primitive man and the victims were regarded as 
malign or benign, as they were offended or placated. They 
became benign and the insane were under the protection 
of a deity, as in Mussulman countries. Later still, the de- 
mon-possession theory gained dominance, and at length the 
demon sank into disease. Throughout all this evolution 
the belief in an inherent affinity between insanity and the 
genius persisted. During the last seventy years this view 
has been advanced with a renewed force by many scientists. 
Most of these practically re-echo the position Moreau de 

*Works, Sydenhold Edition. 



Is Genius a Sport? 



141 



Tours* took half a century ago. Genius, according to Lom- 
brosot, is a degenerative epileptoid psychosis. 

Genius, insanity, idiocy, scrofula, rickets, gout, con- 
sumption and the other members of the neuropathic family 
of disorders are, Nisbett remarks, so many different ex- 
pressions of common evil — an instability or want of equi- 
librium of the nervous system. 

Another view of genius, assuming it morbid, charges it 
to a "sport;" an unequal development of some functions 
at the expense of others. 

Genius, according to Huxley, is innate capacity of any 
kind above the average mental level. From a biological 
point of view a genius among men stands in the same po- 
sition as a "sport" among animals and plants and is a 
product of that variability which is the postulate of select- 
ion, both natural and artificial. On the general ground 
that a strong and therefore markedly abnormal variety is, 
ipso facto, not likely to be so well in harmony with exist- 
ing conditions as the normal standard (which has been 
brought to what it is largely by the operation of those 
conditions), a large proportion of "genius sports" are 
likely to come to grief physically and socially and the in- 
tensity of feeling which is one of the conditions of genius 
is especially liable to run into insanity. 



The same conception is adopted by Havelock Ellis. § 
The hypothesis that genius is a product of morbidity has 
such undoubtedly high authority behind it as to demand an 
examination of the grounds these authorities give for their 
opinions. In logic, any hypothesis to be accepted, must not 
only explain all the facts, but must exclude every other ex- 
planation. No alternative hypothesis must be allowed to 
exist. 

It is undoubtedly true, Maudleyll remarks, that where 
hereditary taint exists in a family, one member may some- 
times exhibit considerable genius while another is insane 

*La Psychologie Morbide. 

^Alienist and Neurologist, 1891. 

{Insanity of^Genius. 

§New Spirit: Study of British Genius. 

HPathology of the Mind. 



142 



J as. G. Kiernan. 



and epileptic, but the fact proves no more than that there 
has been in both a great natural sensibility of nervous 
constitution, which under different outward circumstances or 
internal conditions, has issued differently in the two cases. 
Such a condition, moreover, is not characteristic of the 
highest genius, since anyone possessing it lacks by reason 
of his great sensibility, the power of calm, steady and 
complete mental assimilation and must fall short of the 
highest intellectual development of the truly creative imag- 
ination of the greatest poet, and the powerful, almost intui- 
tive, ratiocination of the greatest philosopher. His insight 
may be marvelously subtle in certain cases but he is not 
sound and comprehensive. Although it may be said then 
by one not caring to be exact that the genius of an 
acutely sensitive and subjective poet denoted a morbid 
condition of nerve element, yet no one after a moment's 
calm reflection, would venture to speak of the genius of 
such as Shakespeare and Goethe as arising out of morbid 
conditions. 

That the facts advanced by Moreau de Tours, Lombroso 
and Nisbet admit of more than one explanation I have else- 
where shown.* Nisbet and Lombroso are peculiarly desti- 
tute of judicial spirit and lack ethnologic, sociologic, bio- 
logic and pathologic perspective. Nordau is a newspaper 
scientist, whose statements contradict themselves, as I have 
elsewhere shown. t Nisbet makes ague a neuropathic dis- 
order. If such tests are to be adopted in defiance of cur- 
rent protozoology every aetiology, except the neuropathic, 
vanishes from medicine. Nordau, to make out a case 
against Ibsen, denies facts proven by numerous alienist 
clinicians. \ Finding that Americans bought his "Degen- 
eracy" largely, Nordau denied in the teeth of his remarks 
on Walt Whitman, that "Degeneracy" applied in the 
slightest degree to America. § This is amnesia, incompara- 
ble with scientific skill or mendacity, which deprives the 
liar of all right to the title 'scientist.' 

*Alitnist and Neurologist, 1891-92. 

t Alienist and Neurologist, 1895-6. Medicine, 1905. 

\Medicine, 1905. 

§Are Americans Degenerate?— Alienist and Neurologist, 1896. 



fs Genius a Sport? 



143 



To the limitedly educated mind of the average philis- 
tine, insane delusions seem akin to poetic fancy because he 
has never passed from the tyranny of custom and, to his 
misoneism, novelty is productive only of uncer. Indeed 
the delusions of the insane are so much akin to his own 
mental limitations that he is very apt to look upon them 
as evidences of sanity, while he denounces the fancies of 
the poet or artist, the opinions of the scientist or the creed 
of the ethical teacher, which cause him more mental per- 
turbation, as emanations from cranks. In politics this type 
of philistine has more than once denounced the "golden 
rule" as the "iridescent dream" of a lunatic. Such 
Philistinism pleases the misoneism of the mediocre, whence 
the enthusiasm over platitudes and the reign of the philis- 
tine in newspaper art, literature and science, and whence 
the frequent repetition of Horace's epigram. 

A "sport" is a marked sudden departure from the 
type. But is genius such a departure? The great man, 
according to Herbert Spencer,* along with the whole gen- 
eration of which he forms a part, along with its institutions, 
language, manners and its multitudinous arts and ap- 
pliances, is a resultant. The genius of the great man de- 
pends upon the long series of complex influences which 
have produced the race in which he appears and the so- 
cial state into which that race has grown. All those 
changes of which he is the proximate initiator have their 
chief causes in the generation he is descended from. 

This is the evolutionary view and it practically dis- 
poses of the "sport" and the occultly morbid notion of 
genius. That all the biologic facts advanced by Lombroso 
Huxley can be explained along this line, a brief examination 
will demonstrate. 

Slow accretion, as an article on Idiosyncrasiest several 
years ago demonstrated, is sufficient to produce all the phe- 
nomena of genius and evidences are found of such accre- 
tion. The Elizabethan epoch was one of giants in all de- 
partments of humrin thought. Shakespeare does not stand 

*Principlea of Sociology. 
t"Mind," 1884. 



144 



J as. G/'Kiernan. 



alone. There is a galaxy of thinkers — Ben Jonson, Willis, 
Helkiah Crooke, Beaumont, Fletcher, Ford, Marlow, Greene, 
Drake, Bacon, Raleigh, Spencer and Sidney are sufficient to 
recall this fact. Shakespere and these owed much to the 
Italian renaissance.* Shakespere's adaptation of Greene's 
novel, "Pandousta," into the "Winter's Tale," drew forth 
Greene's denunciation of a "miserable shakescene decked 
out with our feathers." Indeed, the whole age and, that 
preceding and succeeding, is replete with intellectual stir. 
The influence of these factors of evolution has been fully 
recognized by Macaulay when he says that Bacon's intel- 
lect in an age of Scottists and Thomists would have run 
to waste, as did intellects no less great. Scott was the 
typical Lowland Scotchman of his period. The transition 
to Scott is easy from the pithy humor and songs of number 
less Anglo-Celtic Lowlanders. 

In the biologic phase there are two standards, as Have- 
lock Ellist remarks. The first is constituted by the child 
and its anatomical and physiological characteristics. The 
second is constituted by the characters of the ape, the sav- 
age and the aged. The foetal evolution which takes place 
sheltered from the world is in an abstractly upward direct- 
ion, but after birth all further development is merely a 
concrete adaptation to the environment, without regard to up- 
ward zoological movement. The infant ape is higher in the 
line of evolution than the adult, and the female ape, by 
approximating to the infant type, is somewhat higher than 
the male. Man, in carrying on the line of evolution, 
started not from some adult male simian, but from the in- 
fant ape, and in a less degree from the female ape. The 
human infant bears precisely the same relation to his 
species as the simian infant bears to his, and we are 
bound to conclude that his relation to the future evolution 
of the race is similar. The human infant presents in an 
exaggerated form the chief distinctive characters of human- 
ity — the large head and brain, the small face, the hairless- 
ness, the delicate bony system. By some strange confus- 



*Roscoe. in his "Italian Novelists," points out Shakespere's debt to these. 
|Man and Woman. 



Is Genius a Sport? 



145 



ion of thought we usually ignore this fact, and assume that 
the adult form is more highly developed than the infan- 
tile form. From the point of view of adaptation to the en- 
vironment, it is undoubtedly true that the coarse, hairy, 
large- boned and small -brained gorilla is better fitted to 
make his way in the world than his delicate offspring, 
but from a zoological point of view, we witness anything 
but progress. In man, from about the third year, for- 
ward, further growth — though an absolutely necessary 
adaptation to the environment — is to some extent growth in 
degeneration and senility. It is not carried to so low a de- 
gree as in the apes, although by it man is to some extent 
brought nearer to the apes, and among the higher human 
races the progress toward senility is less marked than 
among the lower human races. The child of many African 
races is scarcely, if at all, less intelligent than the Euro- 
pean child, but while the African as he grows up becomes 
stupid and obtuse, and his whole social life falls into a 
state of hide-bound routine, the European retains much of 
his childlike vivacity. And if we turn to what we are 
accustomed to regard as the highest human types, as repre- 
sented in men of genius, we shall find a striking approxi- 
mation to the child types.* Figure I shows what the 
child should become and what it actually becomes by sac- 
rificing to the conditions. The child is not an undeveloped 
man, but man is an imperfectly developed child. Man, as 
1 have elsewhere pointed out, is a compound animal in 
whom certain structures have their own nervous system 
and their own life, but under control of the central nervous 
system. Man is an aggregate whose internal actions are 
adapted to counterbalance its external actions. t Preserva- 
tion of its movable equilibrium depends upon its develop- 
ment and the requisite number of these actions. Movable 
equilibrium may be destroyed when an action is too great 
or too small and through deficiency or need of some organic 
or inorganic factor in its surroundings. Each individual can 
adapt itself to these changeable influences in two ways; 



*Talbot: Developmental Pathology. 
fHerbert Spencer: Principles of Biology. 



146 



J as. G. Kiernan. 



either directly, or by producing new individuals which will 
take the place of those in whom the equilibrium has been 
destroyed. Since the forces preservative and destructive 
of the race cannot counterbalance each other, the equilib- 
rium must establish itself in an orderly way. Since there 
are two preservative forces — the impulse of every individ- 
ual to self-preservation and the impulse to the pro- 
duction of other individuals — these must vary in an inverse 




Figure I. Child Potentiality (Talbot.) 
ratio. The former must diminish when the latter aug- 
ments. These two forces are therefore necessarily antago- 
nistic. In the evolution of the compound organism, cells 
and structures have surrendered their reproductive powers 
for the benefit of the whole organism. Through what A. 
H. Thompson calls suppressive economy, local degenerations 
hence occur for general benefit. 

The embryonic history of lower invertebrates is essen- 
tially that of the human organs. Vertebrate embryos, all 
of common type at their origin, assume successfully many 



Is Genius a Sport? 



147 



common forms before definitely differentiating. Supernumerary 
organs exist in these common forms at one phase of embryogeny 
For these reasons repetition of teratologic types occur in 
vertebrates. The higher vertebrate embryo, moreover, con- 
tains in essence the organs and potentialities of all lower 
vertebrates. Under the influence of heredity or accidental 
defect, an organ, structure, or function constant in a species 
may be lacking or excessive in an individual without dis- 
tant atavism being involved. Varying conditions stimulate 
these embryonic potentialities at the expense of the later 
acquired and more typical human organs. Thus results a 
struggle for existence between organs and structures, early 
observed by Aristotle, Goethe and St. Hilaire, but fu'ly 
demonstrated by Roux* two decades ago. He, while ad- 
mitting determination by heredity, shows that there are 
surrounding forces necessary, not simply the condition of 
activity by an essential element of the final product. The 
contrasted views of Weissmann and Goethe are thus har- 
monized by the existence of an internal or physiologic 
struggle for existence between the organs, the cells and the 
protoplasmic molecules, of the organism. The principle 
back of development of tissues and organs is overcompen- 
sation of what is used. 

This permits self-regulation and is a necessary pre- 
condition of life. Living matter, unlike inorganic, presents 
an external continuity despite change of conditions. To 
effect this assimilation must always be in excess (overcom- 
pensation), for if less than consumption, the organism 
comes to an end of itself. If equal conditions result, 
change and nourishment will fail or injurious events will 
cause destruction. Continuance can only be assured when 
more is assimilated than is consumed. Fire, for example, 
assimilates more than it uses — i. e., it always has energy 
left over to kindle new material. Fire would (like life) 
become eternal did it not use up material quicker than 
other processes can make it. 

In the same way organisms assimilate more than they 
can consume, but they do not turn all they use to assimi- 

*Die Karapf der Thiele in Organismus. 



148 



J as. G. Kiernan. 



lation; energy remains over by which the process per- 
forms something. This work product controls the exces- 
sive assimilation which otherwise would come to an end 
by not having sufficient material to assimilate. The more 
complex processes of life are hence essentially a radiation 
of assimilation* which is similar to, but not identical with 
combustion, the load which it carries favoring its continu- 
ity. This radiation, load, or work- product becomes directed 
by natural selection to keep up a supply of food primarily 
by moving the assimilating mass. Performance of function 
over and above assimilation is just as necessary 
a condition of continuous assimilation as assimilation is of 
performance. On the other hand, there comes to be an 
inverse relationship between growth and production (with- 
in limits), and capacities result which, although they use 
up material, do not in themselves increase assimilation. 

The course of development consists in properly direct- 
ing this work-product. This so far represents merely a 
continuous productibility of function in connection with 
assimilation. A productibility which is stored up and 
discharged by an outer stimulus of environment will be 
more economic and will give rise to what is called reflex 
excitability. When the reflex work-product dominates, ac- 
cording to circumstances, function will sometimes be greater 
and sometimes less. If, under these conditions, assimila- 
tion keeps on continuously, there must sometimes be an 
overplus, sometimes a balance, and sometimes an excessive 
function, death, and thus elimination. To avoid this last it 
is necessary that assimilation should depend upon use or 
upon a stimulus which use calls forth. From the psychic 
side stimulus is recognized as hunger. 

This process where stimulus is an indispensable factor 
is more special and limited than the more general process 
of assimilation plus movement, etc., but has characteristics 
which favor it greatly in the struggle for existence. Con- 
nected with the most complete self- regulation of function - 
ation is the greatest saving of material. While parts ac- 
cording to their use are strengthened and grow, the un- 



*Scott: American Psychologic Journal, 1888. 



Is Genius a Sport? 



149 



used degenerate and the material for their substance is 
saved. This kind of process unites the greatest economy 
with the highest functionation of the whole, but at the 
cost of the independence of the parts. Senescence be- 
comes thus a result in differentiation, in which the parts 
exist merely on account of the function which they per- 
form for the whole. The senescing organs, under the sup- 
pressing phase of the law of economy of growth, wither and 
even descend in this condition from generation to genera- 
tion, which fact often allows a fresh start in development. 
During the course of a lifetime the organism moves from a 
more general, more easily impressible condition to one more 
perfectly mechanized. Through a long period it becomes, 
by the continuous working of a given stimulus, more com- 
pletely adapted to itself, more differentiated, and thereby 
more stable, so that an always increasing: opposition is 
formed to the additional development of new forms and 
characteristics. 

This law of economy of growth governs the relation 
of the organs to each other and the operation of the pro- 
cess whereby one structure is sacrificed for the develop- 
ment of another. Since* certain parts in the evolution of 
organs disappear, and in the evolution of organisms certain 
organs through suppressive economy, and since the disap- 
pearing and developing tendency of necessity centers 
around the time when certain functions are to be lost by 
the disappearing, and others gained by the developing, 
periods of stress occur around which the law of economy 
of growth centers the struggle for existence between parts 
of organs and between organs themselves. It is because of 
this that physiologic atrophies and hypertrophies and their 
reverse occur. Nearly all conditions of physiologic disturb- 
ance may result at these periods of stress from the in- 
fluence of maternal nutrition or environment, or of heredi- 
tary factors. 

In intra-uterine development, the disappearing and de- 
veloping tendency is peculiarly well illustrated in the em- 
bryogeny of the genito-urinary system, which in all verte- 



*D« Moor: Evolution by Atrophy. 



150 



J as. G. Kiernan. 



brates contains rudimentary organs. The first stage in the 
formation of the kidney system is the pronephros, which 
consists of intricate canals opening into the body cavity at 
the point where the glomeruli are formed on the subin- 
testinal vein. These canals originally had apertures to the 
exterior. Later on they became connected with one excre- 
tory canal opening into the cloaca. The primitive genital 
gland was situated close to the pronephros. In process of 
embryogeny the mesonephros, at first distinct from it in 
origin, replaces the pronephros. The mesonephros in ap- 
pearance (a secretory urinary gland with its secretory 
canal, segmented duct) closely resembles the pronephros. 
The urinary system thus formed continues to be closely 
connected with the genital gland, the discharging canal of 
which passes through the mesonephric kidney to find exit 
through the segmental duct. During the mesonephric 
stage Muller's duct forms, starting from the cloaca and 
opening out into the general body cavity. The meso- 
nephros does not become the permanent kidney, in course 
of embryogeny the metanephros (the permanent excretory 
gland) develops. This development is attended by import- 
ant modification; further instances of degeneration occur 
and fresh organic connections are established. In the male 
the mesonephros begins to atrophy. The part connected 
with the testes is transformed into the epididymis and the 
vas deferens. The remaining part atrophies. When the 
permanent organization is attained, the atrophied part per- 
sists as a paradidymis and a hydatid — organs without 
functions in the adult state. The discharging canal, which 
during the mesonephric stage is common to both urinary 
and genital glands, remains simply in connection with the 
testes and then becomes the vas deferens, the terminal ex- 
tremity of which (the cloaca having disappeared) becomes 
gradually individualized. The permanent kidney is con- 
nected with a fresh canal — rhe ureter formed by degrees at 
the expense of the primitive discharging canal and subse- 
quently separated from the latter in order to empty itself in- 
to the bladder. Muller's duct, which first increases in size, 
proceeds at a certain stage to atrophy until all that remains 



Is Genius a Sport? 



151 



are the distal and proximal extremities in reduced organs 
(the hydatid of Morgagni and the male uterus), neither of 
which is functional. The intervening part of the duct re- 
mains to form the canal of Gasser. In the genito-urinary 
male apparatus therefore occur, when adult: organs which 
have come into existence at different times, but which 
have retained their original functions — the testes, the kid- 
neys (metanephros) , and the ureter; organs which are 
functional, but of which the ultimate function differs from 
the original — the epididymis and the vas deferens; reduced 
organs, vestiges of what were formerly active organs — the 
hydatid and the paradidymis; reduced organs, vestiges of 
Muller's duct which becomes active only in the female — the 
hydatid of Morgagni and the male uterus. Kidney develop- 
ment in the female is similar as to physiologic atrophy and 
hypertrophy. In that part of the mesonephros connected 
with the genital gland and the corresponding discharging 
canal, the canal as a rule disappears. Exceptionally it 
forms Gartner's duct. The lower part persists in a 
rudiment (Weber's organ) ; the upper part becomes reduced to 
a small tissue which surrounds the paraovarium and the 
paraoophoron — vestiges of the former mesonephros. Muller's 
duct becomes considerably enlarged, forming the vagina, the 
uterus, and the Fallopian tubes. At the upper end it is 
connected with the hydatid, a vestige of the mesonephros. 
The genito-urinary female apparatus contains some organs, 
the functions of which remain unchanged — the ovaries, the 
permanent kidney, the Fallopian tubes, the uterus, the 
vagina, and the ureter; and some rudimentary organs 
(vestiges of once active organs)— the paraovarium, the 
paraoophoron, hydatid, and Weber's organ. 

The liver has undergone similar changes, being an 
older organ in the ontogeny of vertebrates than the heart. 
Embryologically and morphologically it is composed of two 
distinct parts, one related to excretion and the other 
to secretion, assimilation, sanguifaction, and metabolism. 
These parts are first a branching system of epithelial gall- 
ducts, and secondly a network of hepatic cylinders. 
During the second month of fetal life the liver is relatively 



152 



J as. G. Kiernan. 



enormous; during the third month it fills the greater part 
of the abdominal cavity. After the fifth month the intes- 
tines and other viscera overtake the liver; still the liver 
of the child at birth is twice the size of that of the adult. 
Immediately after birth the liver diminishes. The right 
lobe, always larger than the left, increases in predominance 
after birth. Very early in fetal life the liver becomes the 
principal seat of blood formation. As Claude Bernard has 
shown, the glycogenic function of the liver begins in the 
embryo. After birth the nutritive function of the liver 
becomes subservient to the excretory function. This is 
shown by the atrophy of the hepatic cylinders described 
by Toldt and Zuckerkandl. Arrest of development at cer- 
tain times would produce the diabetic states so fatal to 
children. Such arrest may result from premature senescence, 
from strain arising before but evinced during the first den- 
tition, or from effects of constitutional disorders at early 
periods of stress. While the liver does not entirely lose 
its originally great sanguifactive powers, still these propor- 
tionately decrease with the evolution of the rest of the 
sanguifactive system in the embryo. 

One possibility of the suppressive phases of the law 
of economy of growth is the production of cerebral states 
analogous to those produced in animals so far as the 
encephalic basis is concerned. The neuron passes succes- 
sively through stages corresponding to those which are to 
be found in the adult fish, frog, bird, and mammal. In 
this case development consists in an increasing complexity 
of the cell with no formation of unnecessary rudimentary 
parts. Its ontogeny in man usually repeats in modified 
form the main ancestral stages. This is peculiarly evident 
when the cerebral development of man is compared with 
that of the vertebrate series. 

In fish and batrachia (ichthyopsidas) the cerebral hemi- 
spheres do not cover the region of the third ventricle from 
which the eyes arise (thalamencephalon) . In the human 
embryo of the seventh week, same. 

In reptiles and birds (Sauropsidae) the hemispheres 
cover the thalamencephalon, but leave uncovered the region 



Is Genius a Spott? 



153 



through the period of growth and senescence rapidly. Be- 
sides such obvious evidence of arrested development, minor 
expressions (such as the senile children described by 
Talbot* and Souquest) occur. This may involve the skin 
alone, the rest of the system being comparatively unaffected. 
The truth of the popular opinion of precocity (early ripe, 
early rotten) is illustrated very frequently. Cratemus, a 
brother of Antigonus, was an infant, a youth, adult, mar- 
ried, begat children, and senile in sevc n years. Louis II. 
of Hungary was crowned in his second year, at fourteen 
had a complete beard, at fifteen was married, at eighteen 
had gray hair, and at twenty died. A ten-year-old boy, 
reported by Rhodiginus, impregnated a female. A boy born 
in 1741 had external marks of puberty at twelve months, 
and died senile at five years. Of six cases of early 
puberty in boys cited by Gould, X one viril at one year, 
died senile at five years. Cazeaux reports the case of a 
girl who menstruated at two, became pregnant at eight, 
and a grandmother and senile at twenty- five. Another 
child of three, with the breasts of a woman and genitals 
of a nubile girl, had a senile appearance. She menstruated 
regularly at two. In a case described by Woodruff a girl 
regularly menstruated from two years, and at six years was 
tall, with well developed breasts and a hairy mons veneris. 
In a girl reported by Van der Veer menstruation began at 
four months and continued regularly for over two years. 
She had the features of a child of ten. The labia majora 
and minora were well formed, and the mons veneris was 
covered with hair. 

Premature senility may evince itself in atheroma of 
the arteries at the periods of extra-uterine stress. This 
has been observed rather frequently in the children of 
vegetarians and after the essential fevers. 

Sex, as Drusing's biologic studies have shown, is not 
inherited, but is the result of various factors acting not 
only at the time of impregnation, but at various times 

♦Dental Pathology: Talbot. 

tDegeneracy: Its Causes, Signs and Results. 

JGould's Anomalies. 

%Progres Medical, July 15, 1888. 



154 



J as. G. Kiernan. 



light has been lost, and before the organ has been far re- 
duced by phylogenetic destruction, a veil of black pigment 
is formed over it, completely shutting it off from outer light. 
The nerve disappears completely before birth, its degener- 
ate cells becoming lost in the mesoblastic skeletel tissue of 
that region. At the time of birth the whole eye is en- 
closed in a thick membrane which isolates it. The depo- 
sition of pigment has destroyed any functional activity in 
the lens and retina, but these parts none the less retain 
traces of a complicated structure recalling their condition 
when functional. 

Similar stress has at the proper period, arrested devel- 
opment of brain types in idiots at stages like the brains of 
Sauropsidae (bird and reptilian type). 

The fetal periods of stress of the human organism 
which most deserve attention are those of the senile (or 
sinnan) (Figure II) period of intra-uterine life (which 

occurs about four and a half 
months after conception) and 
the period of sex differentia- 
tion. Arrest at this period 
of senile intra-uterine de- 
velopment, through any of 
the processes which check 
development, may exercise 
peculiar influences on the 
extra- uterine development of 
the child. When produced 
by syphilis (which so fre- 
quently causes the senile 
appearance of new-born 
children) the child, because 
of organs which have un- 
dergone premature senes- 
cence, fails to pass through 
the first dentition, or read- 
ily falls a victim to second- 
ary infections. Precocity, 
Fig. II. whether of the intellectual 

or physical type, is an expression of arrest ^development 
at the senile period which causes the child to pass 




Is Genius a Sport? 



155 



of the optic lobes (mesencephalon). In the human em- 
bryo of the middle of the third month, same. 

In mammals the hemispheres cover the thalmen- 
cephalon (cerebellum and medulla) and the olfactory lobes. 
In the human embryo of the fifth month, same. 

In some mammals even of higher orders (e. g. t some 
Hapalidse) the hemispheres are smooth. In the human em- 
bryo of the middle of the fifth month, same. 

Arrested development of the neurons would imply im- 
perfect power of association and consequeutly imperfect po- 
tentialities for education. 

As the power of passing through the fetal period of 
stress will depend on the condition in which the fetal or- 
ganism is at the time of the period of stress, and as this 
condition of the fetal organism will depend partly on 
factors inherited and partly on the maternal condition, it 
must be obvious that defect in either at these periods of 
stress may so disarrange the struggle for existence be- 
tween the fetal organs that reversionary conditions will gain 
the ascendancy. 

This is true of even such grave conditions as cyclopia, 
in which the pineal body becomes an actual eye, as in cer- 
tain lizards like the sphenodon; while the structures of the 
embryonic eyes normal in men disappear. In the lizard the 
pineal eye passes through the following stages of develop- 
ment: Formation of a hollow outgrowth from the roof of 
the third ventricle of the brain. This little sac elongates, 
changes its direction, and becomes divided into a proximal 
and distal portion. The cells lining the distal part farthest 
from the brain become differentiated into the cell which 
will form the lens, and the cells which will form the retina. 
The distal parts become specialized; the lens, the retina, 
and the stalk of the optic nerve are mapped out. The lens, 
the retina, and the optic nerve become fully formed. At this 
stage the third eye has reached its limit of development. 
There is a well formed retina connected with the brain by a 
special optic nerve. The organ projects strongly from the 
surface of the head, but from this point, owing to the de- 
velopment of the cerebral hemispheres, degeneration be- 
gins. The nerve becomes broken and fatty, and pigmentary 
degeneration occurs in it. At the same time the pineal 
eye having become useless or even harmful to the animal 
possessed of it, before the power of receiving perceptions of 



156 



J as. G. Kiernan. 



thereafter. Long after impregnation, when the embryo is 
already developed, nutrition is still influential and may 
change the tendency even after the sexual organs have de- 
veloped. Poor maternal nutrition may arrest female de- 
velopment, causing reversion to the male type. The psychic 
side of sexual differences should normally, as it often does, 
remain undifferentiated until adolescence. Adolescence is 
affected by the atavistic tendency to simian senility, which 
implies its early onset. This psychic side in the sex is 
ignored, yet the instincts which are transmitted from gen- 
eration to generation (especially those so fundamental and 
universal as the reproductive instincts) may appear even 
where there is congenital absence or rudimentary develop- 
ment of organs upon which the manifestations depend.* 
The psychic manifestations of the sexual appetite may re- 
main indifferent until adolesence, like the indifferent type 
of sexual organs may be of homosexual type (to the same 
sex), of heterosexual (to the opposite sex), or may be her- 
maphroditic (both sexes.) 

Three conditions (infantilism, masculinism and feminin- 
ism) and a mixed state may result from arrest of develop- 
ment before, at, and after sex differentiation in intra-uterine 
life. As the inferior organs and sex nerves are differen- 
tiated ere the psychic phase, this side of sex may be de- 
termined only in extra-uterine life. Practically all three 
are arrested developments of child potentialities. 

( To be continued.) 



*Barrus: American Journal of Insanity, 1895. 



THE TRAMP AS A SOCIAL MORBIDITY.* 



By HARRIET C. B. ALEXANDER, A. B., (VASSAR) M. D. 

Fellow Chicago Academy of Medicine, Member International 
Medical Congress 1906, Physician to Internal Medicine 
Department Mary Thompson Hospital. 

MEDICAL demography, dealing with state medicine and 
state hygiene from the view- point of society organs 
ization, necessarily takes the tramp, as a social morbidity, 
under its purview. This morbidity involves the questions 
of diagnosis, causation and remedy. 

Acccepting the everyday conception, the tramp is a so- 
cial parasite, which, while in part the result of social forces, 
like tolerance of begging, like great wars, like sudden de- 
struction of industries, (by financial revolutions or by ma- 
chinery) is very frequently also the product of congenital ten- 
dencies, aided by bad environment during growth stress, as 
well by breakdowns from nervous and other protracted dis- 
eases. The tramp's wandering tendency is a return to prim- 
itive nomadism. The petty thefts and other anti-social ten- 
dencies are an expression of the spirit which makes the 
negro conscienceless as to the hen roost of the white. 

Vagabondage, the salient characteristic of the tramp, is 
anti- social but wandering tendencies are not necessarily 
vagabondage. 

"Home keeping youth 
Have ever homely wits," 

remarks Shakespeare and the term 'journeyman' preserves 
the old value set upon wandering as a training. The Ger- 
man Wandenjahr — for 'journeyman year' tells the tale more 
strongly. The English-speaking race has developed because 
of its wandering tendencies. 

*Read before the Oivic Conference of the Reform Department Chicago Wo- 
man's Club, Oct. 15, 1904. 

( 157 ) 



158 



Harriet C. B. Alexander. 



Vice and virtue, disease and health, always shade into 
each other and where one ends and the other begins must 
be determined by relative, not absolute tests. At the out- 
set of tramp medical demography such tests are demanded 
for demarcation. 

Tramps include, according to Josiah Flynt,* "out-of- 
works" and "hoboes," which last are the parasitic or anti- 
social class. Both "out of works" and "hoboes" include sev- 
eral types; some verging on the sociologic norm, some 
trenching on the criminal and some approximating the mor- 
bid. The last type implies that there is evidence that 
wandering tendencies may proceed from disease or defect. 

Certain forms of insanity so notoriously produce wan- 
dering tendencies that their victims are called errabund 
lunatics. The degenerative and acquired types of suspi- 
cional delusion are notoriously errabund. The periodic, 
hysteric and epileptic insane are likewise errabund, as are 
also paretic, secondary and senile dements. 

The restlessness born of nerve tire and lessened checks 
on excessive energy in neurasthenia likewise causes erra- 
bund tendencies. The nerve breakdowns of puberty and 
adolescence through transmutation of the normal activity of 
childhood, youth and early manhood, have the same effect. 

The tramp classes therefore contain morbid elements to 
an enormous extent. This is very strikingly shown in the 
late researches of Willmanns.t of Heidelburg, who found that 
of 120 old professional tramps sent from jails to an insane 
hospital, there were but 27 that had escaped the workhouse. 
The number of sentences was high, some having a hundred 
or more. There were 66 cases of puberty breakdown; 19 
of epilepsy; 6 of hysteria; 5 of paranoia; 4 of periodic in- 
sanity; 3 of imbecility and one of cretenism. There were 7 
alcoholic dements, 4 paretic dements, and 1 luetic dement. 
In other words, 104 of 120 cases of insanity among tramps 
were of long existing, unrecognized types. 

The cases were divisible into three groups. Patients 
in the first group were originally sound, mentally and phys- 

*Elli8: Sexual Inversion, Appendix I. 
tNeurologisches Centralblatt, Dec. 15, 1903. 



The Tramp as a Social Morbidity. 



159 



ically, with proper social tendencies and leading orderly lives 
until after the close of adolescence, when a nervous break- 
down occurred and they became tramps and outcasts. The 
second group consists of normal persons who suddenly or 
gradually, without recognizable cause, adopted an unstable, 
irregular errabund life. The third group is composed of un- 
balanced degenerates, who early in life, evinced moral im- 
becility, could not be schooled or trained to a trade, but 
started on a career of vagabondage. 

Does the existence of these groups justify the creation 
of a tramp type? Anthropometric measurements indicate 
that the tramp class has merely characteristics common to 
the congenitally defective. The skull type does not differ 
from that of the races to which the tramp belongs. Dental 
and cranial anomalies approximate closely in number and 
kind to those of the harlot class. 

Harlotry and hoboism are mental and moral defects 
taking lines of least resistance in an "ego" of primitive 
type. The hobo combines the restless wandering tenden- 
cies of the nenrasthenic and suspicional degenerate with 
the parasitic tendencies of the pauper and the egotism of 
the moral imbecile. He therefore fuses several degenerative 
types, while most approximating the harlot pauper, as found 
in Bridewell, workhouse and almshouse. 

The percentage of puberty breakdowns and the per- 
centage of congenital defectives, like that among harlots, is 
greater among tramps than among criminals. 

All moral, intellectual, socialogic and physical expres- 
sions of birth defect occur in tramps. These, under the 
law of heredity transformation occur in all buds of the de- 
generate tree. Pauperism, harlotry, insanity, hysteria, id- 
iocy, moral imbecility, and haemophilia occur in the same 
family and present the same physical stigmata. 

Besides congenital defects, tramps, as shown by Will - 
mann's analysis, present morbid factors acquired after birth. 
Alcoholism, like the vagabond tendency, is very frequently 
an effect, not a cause. Those who have been sunstruck, 
have sustained skull injuries, or have met with railroad 
accidents, become intolerant of alcohol. 



160 



Harriet C. B. Alexander. 



Sunstroke, skull injury and railroad accidents suffice by 
themselves to produce suspicional errabund states. A large 
proportion of the suspicional insane who reach insane hos- 
pitals through almshouses are of this mixed origin — alcohol- 
ism, sunstroke, skull injury, and railroad accidents. Tramp 
breakdowns far from rarely occur among firemen, stokers, 
stationary engineers, cooks and those exposed to great 
heat. Exposure of Americans to tropical climates must of 
necessity, for this reason, increase the tramp class. The 
influence of institutionalism in making the class parasitic is 
at once evident. 

What is true of skull injury, sunstroke and railroad 
accidents is likewise true of protracted invalidism , which 
always tends to parasitic mentality. Patients for this rea- 
son are often pauperized by hospitals and henceforth live 
on the community. Medical charity is therefore a great 
factor in the producton of "hobo" tendencies. 

The great fevers produce, at times, permanent change 
in character by which the patient's relations to his sur- 
roundings are changed in a degenerative direction. 

Periods of financial and other stress shock many into 
apathy, inevitably tending to parasitism likely to be erra- 
bund. The restlessness of the bankrupt merchant is an old 
proverbial observation. 

The sex factor in the production of "hoboism" markedly 
looms up in the fact that but 1/10 of Willmann's cases 
were women. As one-half of these were puberty break- 
downs, it is easy to see how the breakdown led to indis- 
cretions and indiscretions to outlawry. The percentage of 
women tramps in standing army countries is greater than 
in the United States. Woman being altruistically built, is 
of necessity, the great preserver of social institutions. She 
maintains the type from which man ever tends to depart. 
In primitive society, men as hunter, fisher and warrior was 
the nomad, while woman was the home-builder, artisan 
and agriculturist. When militarism declines man approxi- 
mates woman, but tends more to nomadic tendencies, 
whence the tramp tendencies after great wars. 



The Tramp as a Social Morbidity. 



161 



The remedy for vagabondage universally popular is 
that of Dogberry: "You shall comprehend all vagrom men." 
This remedy has proved a source of the very evils it pro- 
poses to cure. It is obvious from Willmann's figures that 
strain at adolescence plays a large part in the ethical 
breakdown of the tramp. Child labor looms up here as a 
potent factor, as European sociologists and poets have re- 
peatedly pointed out. If this labor be such as exposes the 
child to unhygienic surroundings (glass houses, match- 
making, fur-pulling, sweat shops and lead grinding) sus- 
picional errabund states readily occur. Struggle for school 
standing is a fertile source of puberty breakdown, espe- 
cially since mechanical teaching has become the vogue. 

Medical charity, like all charity, indiscriminately admin- 
istered, creates the mind which believes Society owes it a 
living. 

The hobo problem in the United States is largely of 
European creation since before the revolution the bond 
servant system introduced an enormous population of de- 
fectives which, through contract labor up to the days of 
emigrant restriction, was constantly increased. Owing to 
such restrictions the burden of the defective classes has 
greatly increased in Europe of late. 

The influence of labor conditions in producing the 
tramp include not merely strikes, lock-outs and black lists, 
but likewise the dangerous trades. The steel industries 
cause an undue proportion of nerve breakdowns, as do the 
mining and all industries where accidents are a probability. 
Lead industries produce suspicional states. The same is 
likewise the case with industries where dust is a constant 
factor. 

One social danger from tramps is that of homosexuality 
in boys decoyed from home. The tramps gain possession 
of these boys in various ways. A common method is to 
stop for awhile in some town, and gain acquaintance with 
the slum children. They tell these children all sorts of 
stories about life on the road, how they can ride on the rail- 
roads for nothing, shoot Indians, and be "perfeshunnels" 
(professionals), and they choose some boy who especially 



162 



Harriet C. B. Alexander. 



pleases them. By smiles and flattering caresses they let 
him know that the stories are meant for him alone, and 
before long, if the boy is a suitable subject, he smiles 
back just as slyly. In time he learns to think that he is 
the favorite of the tramp, who will take him on his travels, 
and he begins to plan secret meetings with the man. The 
tramp continues, of course, to excite his imagination with 
stories and caresses, and some fine night there is one less 
boy in the town. On the road the lad is called a "prushun," 
and his protector a "jocker." This condition, however, 
occurs among the boys who usually otherwise find their 
way into the reform schools of the various states and 
cities. Among these, as Hamilton Wey of Elmira, New 
York, Randolph Winslow, of Baltimore, Md,. and Kuflewski, 
of Chicago, have shown, homosexuality frequently occurs 
without outside suggestion. 

What, therefore, are the social remedies for the medical 
aspects of vagabondage? First and foremost comes the 
prevention of congenital defects; as most of these defects 
are potentialities rather than actual existences they can be 
largely corrected by proper environment before birth and 
during- the periods of growth stress. Among proper envir- 
onment is sanitation of residences and of food, water, dress, 
etc. Even slight improvements in sanitation effect remark- 
able results. A very slight improvement in a tenement 
house system in New York begun in 1881 had resulted in 
1891, not only in an enormous decrease in infantile mortal- 
ity, but the saloons in the districts affected decreased one- 
third. Improper food during childhood and youth is the 
source of suspicional breakdowns like those of dyspepsia in 
the adult. Impure water causes greatly debilitating diseases 
like typhoid fever, with, as a consequence, neurasthenia 
and brain artery change. While most great fevers are of 
germ origin, the germ needs a soil, which sanitations weeps 
away. 

One remedy suggests itself for the labor phase of the 
tramp problem — increased belief in the mutuality of contracts 
on the part of employer and employed. Importation of defec- 
tives for labor purposes requires more stringent supervision 



The Tramp as a Social Morbidity. 



163 



since, as shown by Willmann, the suspicional and periodic 
insane long pass muster. 

More rigid inspection of workshops and rolling mills 
and greater damages for personal injury would cure the 
accident evil. Society has created its vagabonds, as it has 
created other defective classes. When it alters favorably 
the environment of its youth the creation of defectives will 
markedly diminish. 



THE ENTONING OF THE NEURONES IN THE 
PRACTICE OF MEDICINE AND SURGERY.* 



By C. H. HUGHES, M. D. 
St. Louis, Mo. 

HPHE entoning of the neurones means the sustaining and 
■ rebuilding of the sources and the final conservation of 
nerve center energy. The psychic neurones, occupying the 
highest place and exerting the greatest influence in the 
neuraxis, may be impressed on automatically evolved 
thought. A word fitly spoken to the patient, an auto 
or an external suggestion from another and healthier and 
more active brain and mind; or from an environing in- 
fluence, such as even a picture on the wall, cheerful or 
depressing as the case may be; a well or illy-digested or 
a predigested meal, agreeable or disagreeable to the taste 
or appetite; a primavia clogged or freely opened, a torpid 
liver, congested or freely acting, or other disease oppressed, 
or wrong acting viscera or emunctory, and these impres- 
sing the higher or central presiding neurones exalt or 
lower their vital activity as the case may be, and con- 
tribute to the relief and hopeful exaltation or more or less 
hopeless oppression and depression of the man through his 
psychic and other neurones and the organs they influence 
towards convalescence or fatal functioning and vice versa. 

These neurones in their functioning are the higher 
powers of the organism through which the masterful vis 
medicatrix of the human economy builds up or destroys. 

In my earlier experience as an army surgeon 1 have 
marvelled at the varying results of insignificant and grave 
gunshot wounds received under apparently similar circum- 
stances and environment of the men; the hopefully psychic 

♦Read at Hot Springs Meeting Mississippi Valley Medical Association. 
( 164 ) 



The Entoning of the Neurones. 165 



neurone entoned one with the grave penetrating abdominal 
wound recovering, the hopeless psychically depressed and 
despairing, speedily dying, though treated in a similar way 
externally, are illustrations in point from clinical experience, 
especially our own in the days when we practiced surgery. 

These unexpectedly variant results made in my earlier 
days a profound and searchful impression, and 1 have 
sought ever since for a revelation of the underlying cause 
thereof. And the cause has come to my knowledge, as it 
has to others, in the entoning or the reverse of the central 
neurones that contribute to the makeup of the neuraxis 
and the man. Our predecessors in the healing art saw 
less clearly than we do in the light of present-day psycho- 
neurological illumination and the opsonic index, but they 
discerned it in the dynamia or [adynamia of the strong 
or feeble vis medicatrix naturce, and believed in its existence, 
though in more restricted sense than is now demonstrable. 
But so far back as in the days of Cullen the view of the 
marked influence of the nerve centers, though not then so 
well known as in our day, over the processes of disease 
was accepted, for he said that "from all that he could see 
of the movements of disease they might in a manner be 
called nervous." This view for a time obscured the humeral 
or blood pathologists, and was later penumbrated further by 
the omnipresent bacteriological explanation as the causes 
of nearly all morbid action now somewhat on the wane, 
for these are causes and conditions of the coming of the 
bacteria. 

Neural influences and relations are found in the organism 
which makes even the bacilli and bacteria fail or fall 
or flee before them. The mysterious yet demonstrable 
exaltation, acceleration, retardation or depression or sup- 
pression of function, as in the cardiac, respiratory or intes- 
tinal effect of certain emotions, the Kloptversacht experiment 
of Golz with his frogs; the apepsia through descending vagus 
influence, the cardiac arrest through the same influence 
once too often attempted, by Colonel Townsend's self- 
experiment; the influence of the diabetic center in the floor 
of the fourth ventricle of the brain and its influence on 



166 



Charles H. Hughes. 



abdominal viscera, the tachycardia, bradicardia, etc., through 
various involuntary emotions, all remind us of the impor- 
tance of entoning and promoting the stability of the higher 
neurones of the cerebro- spinal axis in the management of 
disease, and in the promotion of its cure, yet we often overlook 
hese demonstrable facts and well-known relations between 
disease processes and the neuronic and psychoneuronic in- 
strumentalities and helps toward cure, notwithstanding the 
proofs that sometimes also come before us from empirical 
non-medical sources, as in the mind and faith cures in- 
numerable, etc. 

The lesson of all this, not to make this essay too 
prolix, is that there is a therapy favorable or adverse in 
all we say or do to or for the patient, and that we should 
look well to the entoning of the psychic neurones and 
guard against impairing their potent power by allowing no 
depressing lodgment of despair in the patient's mind while 
treating him, by discoursing of the recovery and not the death 
of others similarly afflicted, by permitting no pessimistic 
visitors or nurses to talk of the shroud and the hearse, and 
those like afflicted who have filled them; to promote ample 
rest and reasonable cheerfulness of mind in the patient and 
those who visit him; to avoid overtax of neurone energy 
and secure as much sleep, mental tranquility and nerve 
center repair as possible in every case; to save the centers 
from all possible toxine damage, whether in medical or 
surgical cases, whether auto-toxin or poison from without. 
We should avoid the long, taxing visit, the so-called candid 
but cruel discussion, pro and con, of chances for recovery 
in the patient's presence; the display of hideous keen- 
cutting surgical instruments before the anaesthetic is ad- 
ministered; the flourishing of the hypodermic needle or too 
slowly using it; the long brain taxing, sometimes alarm- 
ing explanations of possible proceedures for relief. In short, 
when disease has prostrated the patient and nature pleads 
for help for all the controlling centers of vital action, let us 
harken unto the voice of vis medicatrix naturce and obey it 
in the entoning, reconstructing, tranquilization of the higher 
central neurones, that can do so much to aid and much, 
also, if wrongly treated, to harm our patients. 



The Entoning of the Neurones. 



167 



Whatever view we now or may ultimately hold of 
the neurones, especially the cerebro-psychic complete cell, 
whether we shall continue to hold the present general, though 
mooted, Cajalian view of its independent, though juxtaposed 
and intimately related cell anatomy, or accept the recent 
cytological criticism as correct and go back to former or on 
to a newer morphography of cell morphology, my plea is 
for the paramount care of the neurones, especially those 
which are aggregated in the construction and function of 
the neuraxis. 

In every case of disease I would seek, as now, a cor- 
rect localizing diagnosis, and minister to the organ, viscus 
or special system; but I would exercise, in addition, a 
watchful care over the tone and integrity of the nervous 
system, especially in its higher central neurones. In short, 
1 would treat the whole man as well as the special spot 
or organ claiming attention. I would endeavor to keep the 
neurones well entoned and thus save the patient through 
those psychically sustaining influences in addition to coarser 
medication, which has sometimes saved him in other and 
unscientific hands, acting under the supreme confidence of 
ignorance, without medicine. We have a double armamen- 
tarium at our command if we combine real and true psychic 
rest and hope with our chemical reconstruction and nerve 
center therapeutics, The right acting neurone is the 
physiological unit of organic integrity and power; when it 
fails, anatomical pathology begins. For salvation of the 
patient conserve his neurones.* 

*A more elaborate yet not complete presentation of this view, as I hope yet 
to have opportunity to make, may be found in my first book on the "Neurological 
Practice of Medicine." 



A PSYCHOLOGICAL MEDICO-LEGAL STUDY. 
The Case of William Rodawald. 



BY G. F. ADAMS, M. D. 

KENOSHA, WIS. 

WE READ in the public print of the ."Crime of Amal- 
gamated" and high finance. Public speakers and 
editorial writers tell us that the country is money mad. 
We are almost daily startled by reports of criminal acts 
committed by people heretofore law-abiding, many of whom 
have enjoyed a state and national reputation as trusted 
citizens. We have had startling examples in our immediate 
vicinity during the past year. For instance: The Bigelow 
case at Milwaukee, the Dougherty defalcation at Peoria, 
and in Chicago we had the Bank of America. 

This leads up to the question: Why do men and 
women commit crime? To be able to consider this ques- 
tion at all, we must know not only the details of the 
criminal act, but we must know more. We must be 
familiar with the normal mental state of the criminal, and 
the environment that surrounded the law-breaker prior to 
his or her departure from the straight and narrow path. 

After the crime has become a public act, and the law 
steps in to prosecute, we have only too frequently the 
defense — insanity. In cases of this kind, the professions of 
law and medicine must work together to justly determine 
the question of responsibility, so that society shall be pro- 
tected, and the majesty of the law upheld. How this was 
done in the case of William Rodawald will be the Medico- 
Legal part of this paper. 

The crime for which William Rodawald paid the full 
penalty of the law was committed in the village 'of Sala- 
manca, N. Y,, April 7th, 1903. 

( 168 ) 



A Psychological Medico -Legal Study. 



169 



At that time 1 was connected with the New York State 
Hospital service. Ten days after the murder I received 
the following letter from the Dist. Attorney. 

Office of the 
George W. Cole, DISTRICT ATTORNEY 

District Attorney. of Cattaraugus County, 

Salamanca, N. Y. 

Salamanca, n. y., April izth, 1903. 

DR. G. F. ADAMS, 

Gowanda, N. Y. 

Dear Sir: — 

A murder recently occurred at West Salamanca in this 
County, in which William Rodawald, a German, or Polander, 
shot and instantly killed a young man by the name of 
Jesse F. Bayer. I apprehend that the defense will claim 
that Rodawald was insane, although I have known him for 
some time, and know him to be simply a high-strung, 
vicious man, with an ungovernable temper, and no disposi- 
tion to control it. 

I think it would be well to have him examined now 
by an expert alienist, and if that defense is set up, to 
have such testimony at the trial, which will doubtless oc- 
cur the latter part of May or the latter part of June. If I 
desire, would you come to Little Valley (where Rodawald 
is confined in the jail) and make an examination quite 
soon, when notified, and would you testify at the trial, if 
your testimony should be of service to the prosecution after 
making your examination? 

Kindly let me hear from you, letting me know if you 
will make the examination, and if you will be at liberty to 
be a witness if desired. 

Yours very truly, 

G. W. COLE, 
Dist. Atty. 

My reply to this letter was a provisional acceptance 
that Dist. Attorney Cole met more than half way. I told 
the District Attorney that I would examine Rodawald in the 
county jail at Little Valley, N. Y., on condition that if I 
found the prisoner insane that he would not prosecute him 



170 



G. F. Adams. 



for the crime of murder, or if he did try him, I was to be 
free to appear for the defense. His reply was that "all 
he was after was justice." "That he did not seek to con- 
vict a man of a crime when he was not responsible for his 
act, and that his only wish was to be advised about the 
proper course to pursue." 

Soon after 1 visited the prisoner in the county jail, and 
spent the entire day with him. My official report to Dis- 
trict Attorney Cole will cover the salient details of the 
crime, and give my opinion of the prisoner's mental state. 

EXAMINATION OF WILLIAM RODAWALD AT THE 
REQUEST OF GEORGE W. COLE, DISTRICT 
ATTORNEY OF CATTARAUGUS COUNTY. 

William Rodawald. Age 49. Occupation, tannery la- 
borer. Born in Germany. In this country about 14 years. 
Married. Now living with his third wife. 

In jail at Little Valley awaiting the action of the Grand 
Jury for shooting Jesse F. Bayer at Salamanca, N. Y., 
April 7th, 1903. 

I first saw Rodawald in the jail corridor, having been 
admitted with two of his friends, and there had an oppor- 
tunity to observe him while visiting with them. He was 
quiet, collected, in no sense excited, nor was he depressed. 

Later I saw him in the presence of the turnkey in the 
sheriff's office; was simply introduced to him as a physician. 
He did not ask who I was, nor express any interest why I 
was there; talked freely and was quiet and easy in his 
manner. Gave me information concerning his birth, occu- 
pation in Germany, when he came to this country, where 
he had worked and common facts concerning his family, 
and how long he had been in jail. Many of these facts I 
have since confirmed by inquiry from other sources. 

PHYSICAL EXAMINATION. 

His general appearance good; muscles hard; hands show 
that he is accustomed to hard labor; tongue clear and 
steady; eyes bright and react to light and accommodation. 
When asked to stand, close his eyes and turn around or 



A Psychological Medico -Legal Study. 



171 



walk from one side of the room to the other, was a little 
uncertain but did not stumble. Knee reflexes slightly ex- 
aggerated; no particular zones of skin anaesthesia. 

Says that his appetite is good, though when first ad- 
mitted to the jail he felt discouraged, realized his position 
and for a few days he did not eat as much as usual. Now 
sleeps well. 

His physical health 'rom his point of view was good; 
very seldom has he ever been sick. He gives a history of 
having been injured about fifteen years ago; not very cer- 
tain about the date, but while he was living: in Germany. 
He was struck on the head with a spade and this blow left 
a scar over an inch and a half long in the left temporal - 
parietal region. He claims that he was unconscious for 
several hours after this injury and that he was confined to 
his bed for six weeks. He understands that his skull was 
fractured at the time he was struck, but from an external 
examination no line of fracture can be determined now. 
He is tender from pressure in the region of the injury. 
Since the injury to his head, has occasionally had severe 
headaches. The most severe attack of headache he ever 
had was about one year ago, when he states that for two 
weeks he was too ill to work. During attacks of headache 
he suffers most in the region of the head injury. (His wife 
says she has no remembrance of his having been sick and 
unable to work for two weeks in the twelve years they 
have been married.) 

I spent over an hour with him alone. He described in 
detail the shooting of Bayer, in substance as follows: 

He had finished his work in the tannery, drew his pay 
and on his way home stepped into a saloon and drank two 
glasses of beer. His wife and boy, thirteen years old, 
met him before he arrived at his home and they picked up 
some railroad fence posts lying- beside the railroad and 
started to take them to the house. A neighbor woman 
called to him to let them alone, that the posts were her 
property. He claims that the section boss gave the posts 
to him and he continued on towards the house with the 
posts; that a man (Bayer) he cannot recall his name, but 



172 



G. F. Adams. 



he refers to him as the "sailor man," came out about 
the time the woman spoke to him and told him to let the 
posts alone, made threats and when he refused to drop the 
posts, drew a knife; that the woman returned to her 
house and soon came out with a butcher knife, and that 
about that time a negro who lived near by also became 
mixed up in the quarrel. He dropped the posts, ran into 
the house, picked up a revolver that belonged to his son 
and came out to protect his wife and son. He claims he 
believed the "sailor man" and "the woman with the butcher 
knife" were likely to do them harm. He says he did not 
present the revolver to Bayer as if to shoot, but in the 
rush towards him he stumbled and Bayer placed his hand 
upon his shoulder, or his coat collar, and the revolver went 
off accidentally and shot the "sailor man;" that he had no 
intention of shooting him; that now he regrets it very 
much and appreciates the fact that he must face a grave 
charge in court. 

In regard to his ideas, he does not claim to know of 
any enemies that he has and says that he never had any 
trouble with the man whom he shot, in fact barely knew 
that there was such a man living in Salamanca. He admits 
having seen him before. He had at one time some trouble 
with the woman. He said that he went to the police justice 
to swear out a warrant for her, but he failed to get the 
warrant. He claims that he is a man of peaceful disposi- 
tion, does not fight and is on amiable terms with his asso- 
ciates. He does not believe that he is being persecuted. 

He takes up general subjects and discusses them freely 
and frankly; spoke of being a subscriber to a German 
newspaper; said that he did not read English but that he 
liked to read his German paper; spoke freely of his work 
at the tannery and of the different kinds of labor that he 
had been doing since he lived in Salamanca; spoke of his 
family; referred to his three marriages; told about getting 
into trouble in Germany and as a result was sent to jail 
for nine months; explained the trouble as having been a 
general fight among laborers, and said there were about fif- 
teen men all sent up for the same length of time. 



A Psychological Medico -Legal Study. 



173 



He is entirely free from everything in the line of a de- 
lusion; he is able to reason correctly from his point of view; 
has no hallucinations. His general perceptive faculties for 
one of his education and environment are good. 

I again saw him in the presence of his wife and son, 
and she corroborated a number of the statements that he 
made to me at the time of the first examination. 

Again I saw him alone, and I went over with him in 
detail the time of the homicide, and he did not change or 
vary his statements in any material way. 

I also saw a man who called on him in the jail — a 
man who had known him for several years and at times 
had worked with him — and asked him how Rodawald im- 
pressed him at the present time. His statement was un- 
qualified in saying that he could not see any difference in 
him now from any time. This man also saw Rodawald a 
very short time, half an hour, before the shooting. He met 
him going from his work to his home that night and stopped 
and talked with him, and at that time he appeared to be 
as he had always known him. 

CONCLUSION. 

From my examination of William Rodawald, I am un- 
qualifiedly of the opinion that he is in his normal mental 
condition, that he is able to realize his position, and that 
he does appreciate that he has committed a crime in shoot- 
ing Jesse F. Bayer, and was in every respect responsible 
for his act at the time ef the shooting. 

Dated, Gowanda, N. Y., April 24th, 1903. 

(Signed) G. F. ADAMS. 

The evidence at the trial as given by five eye wit- 
nesses was positive that Bayer did not have a knife in his 
possession at the time of the shooting; nor did the woman 
who claimed the posts have a butcher knife or any other 
knife or weapon. The witnesses for the prosecution also 
swore positively that Rodawald went into his house saying 
that he was going for a gun to shoot the "sailor man," and 
when he came out of the house with the revolver in his 
hand, he rushed up to Bayer and fired point blank at him, 



174 



G. F. Adams. 



and after Bayer fell shot through the head, Rodawald stood 
over him swearing, flourishing his revolver and threatening 
to shoot again, if the shot he had already fired had not 
done its deadly work. Soon after the shooting Rodawald 
said to those present, that he would give himself up, and 
he did so as soon as he could find an officer; remarking 
that he had shot a man and wanted to be locked up. 

The trial did not develop any special incident of note. 
The defense did not try to prove the prisoner was insane 
except by inference. 

Rodawald was sworn in his own defense and made a 
good appearance on the stand, relating the same story to 
the court and jury that he did to me at the time I exam- 
ined him in jail only more in detail, under the careful ques- 
tioning of the attorneys. The jury took but a short time 
to decide that the prisoner was guilty of murder in the first 
degree. 

As the judge pronounced sentence of death by electro- 
cution upon him, he collapsed but soon recovered and from 
that time was a model prisoner all the time of his residence 
in the death house in Auburn prison. 

THE PSYCHOLOGICAL QUESTION. 

Let us go back in the history of William Rodawald 
three or four years. He was employed by the same tan- 
nery piling bark. His attention was attracted to three 
young men running across an open field near the bark pile 
he was on. A man was pursuing them and calling them to 
stop. He ceased his work and watched carefully the ac- 
tions of the pursued and the pursuer. He saw three young 
fellows, about eighteen or twenty years old, evidently try- 
ing to get away from an older man who was shouting to 
them to surrender, and when they did not stop, the older 
man raised a revolver and fired at the three boys. One of 
them fell fatally wounded. 

Rodawald saw all this for he was only a short distance 
away. He had never seen a man shot to death before, and 
the tragedy made a profound impression on him. He was 
the only person who saw the whole of the shooting. 



A Psychological Medico -Legal Study. 175 



The facts pertaining to the shooting are in substance as 
follows: The Erie R. R. that runs through Salamanca, N. Y., 
had been losing freight from its cars. Thieving was so 
very bold and common that the Railroad Company sent a 
special detective, by the name of Wheeler, to protect its 
property. One day Wheeler was patrolling- the R. R. yard 
when he saw three boys by some loaded freight cars, and 
thinking he had probably discovered a gang of thieves, 
started in pursuit. The boys ran out of the yard across the 
field with Wheeler close after them, calling to them to sur- 
render. As a matter of fact they were not thieves, and at 
the worst, in the eye of the law, could only be considered 
as simple trespassers. When the shot was fired the young 
men were not on the railroad property. Soon after Wheeler 
was arrested and tried for the killing of the young man. 
Rodawald was the star witness in the trial. The jury dis- 
agreed, which necessitated a second trial of the case, and 
the jury brought in a verdict of assault; so the judge im- 
posed as the only punishment a fine of #600. This fine 
was paid, and Wheeler was a free man. When Rodawald 
heard the result of this conviction of assault, and that only 
a fine of $600 had been imposed, he threw up his hands 
in disgust, and exclaimed: "Hell of a country — shoot a man 
— fine him $600 — hell of a country." What do you think of 
Rodawald's conclusion? 

William Rodawald was born and reared in Germany, 
where the law of the land is enforced. He had met the 
stern hand of the German law, had been arrested, con- 
victed and served a term in prison for no greater crime than 
a free fight among a gang of laborers. He had a most pro- 
found and wholesome respect for law and order. More than 
all this, he had tried to do his duty, as he saw it, by ap- 
pearing in court as a witness in a murder case, and yet in 
spite of the fact that a murder had been committed, and he 
knew of this murder more fully than any other person, the 
only punishment inflicted was a small fine. Do you wonder 
that he said "Hell of a country?" 

If you had been brought up as Rodawald was to respect 
and fear the law, had witnessed a murder as he did, been the 



176 



G. F. Adams. 



star witness in two trials of the murderer, and the whole at- 
tempt of the majesty of the law to punish the criminal had 
resulted practically in his acquittal, do you not believe — do 
you not know a great and lasting impression would have 
been made on you? 

Would William Rodawald have shot Jesse F. Bayer if 
he had not been impressed that this was a "Hell of a 
country?" 

THE PENNOYER, 

Kenosha, Wis. 



PSYCHOLOGICAL STUDIES OF MAN'S MORAL 
EVOLUTION.* 

THE CREEPING SERPENT IN OUR GARDEN OF EDEN. 



By ALBERT S. ASH ME AD, M. D., 

NEW YORK. 

GROPING in the dark, like a blind man, I cannot see 
plainly. Yet the light of Christian day is perhaps 
the most favorable that "Kind Nature" is able to present. 

I use "blue" ink in analyzing this subject, for the 
reason that I can see it reasonably well. The blacker ink 
of utter despair would require straining effort. 1 cannot 
much longer escape "the knife," unless I decide to do with- 
out it. My light then would be entirely out. 

The Dogmatist will say ''Nemesis." Let him remem- 
ber Milburn, the blind preacher, and Dr. Love and his 
fatality. 

The term "Law of Evil" is good, but not all embrac- 
ing as is the term "Law of Demolition." 

All sickness is the dastardly work of the organic Law 
against Man and Mankind. It is the principle of destruc- 
tion at work. Matter, Mind and Morals ever under attack, 
and man quarrelling with man labors in vain for self-pres- 
ervation, for harmonious life until the admitted necessary 
total darkness of death. The blind lead the blind toward 
altruism, and find it not. 

The Law of Demolition admits no division of responsi- 
bility. The Great Cause is the cause of all features of life, 
and Man, individually and collectively, is only an exhibit of 
the work of Nature, The Great Criminal, that "can smile 
and smile, and be a villain still." 

I know no difference of meaning between the term God 
and the term Nature. 



♦Continued from February, 1907. 

( 177 ) 



178 



Albert S. Ashmead. 



Rasselas states it well: — "The angels of affliction spread 
their toils alike for the virtuous and the wicked; the mighty 
and the mean." 

But we see that the virtuous are continually assailed 
and perverted, becoming themselves, agents of and for the 
destroying quality. So where is the sensible reason for as- 
suming that a kind God exists when we see that Evil is a 
feature of the Organic Law? 

One half of it. 

No — it is All One. 

I believe that as to the essential views I have ex- 
pressed from time to time there can be no dissent upon any 
one's part. We go our respective ways at the signboard 
"Faith": One way leads to the ever receding sun mock- 
ing the birth of a new day of life. Mine leads to the dark- 
ness into which I deliberately go, wholly heartbroken, with 
the delusions and illusions, and treacheries of that God, 
that was preached to me as a Harbor and a Guardian. I 
will be no longer a credulous listener. If one finds comfort 
in Faith, it is one's duty to support it and be by it sup- 
ported. As my days near their close, I become more bitter. 
"There is no God" said the Psalmist. 

Let us see what "words, idle words" or language, can 
tell us of our subject. 

In the "dark backward and abyss of time," animals 
and man had the power of speech. For Talmudic tradition 
tells us this, also Biblical history. 

In the account of Man's creation and his fall in the 
book of Genesis, we read that the Serpent, more subtle 
than any beast of the field, said unto the woman: 'Yea, 
hath God said; Ye shall not eat of every tree of the Gar- 
den,' and the woman said unto the Serpent; 'we may eat 
of the fruit of the trees of the Garden. But the fruit of 
the tree which is in the midst of the Garden, God hath 
said, Ye shall not eat of it. Neither shall ye touch it, lest 
ye die. And the Serpent said unto the woman, Ye shall 
not surely die. For God doth know that on the day ye 
eat thereof then your eyes shall be as God's, knowing good 
and evil, etc,' and they ate of the fruit and the eyes of 
them were opened. 



Man's Moral Evolution. 



179 



And the curse of the Lord was to the woman; in 
sorrow thou shalt bring forth children. And to the man, in 
sorrow shalt thou eat of it all the days of thy life. Thorns 
also and thistles shall it bring forth to thee. And thou 
shalt eat the herb of the field. In the sweat of thy face 
shalt thou eat bread, till thou return unto the ground; for 
out of it wast thou taken: from dust thou art, and unto 
dust shalt thou return. 

Herein we discover no surprise at the power of speech 
residing in the serpent. God even addresses a special curse 
to him; and his subtlety over the other beasts is alluded 
to: "Thou art cursed above every beast of the field; upon 
thy belly shalt thou go." 

What was the curse of those other beasts of the field? 
Was it denial to them, or abolition of speech? In the 
world's history, down to the dispersion of the human race 
at the building of the Tower of Babel, language is sup- 
posed by some philologists and antiquarians to have been 
Mayan. And this language, if any at all, if it was really 
the oldest, was that spoken by those beasts of the 
field, or only the serpent, in the "Garden of Eden?" And 
as the serpent understood what was said to him there, this 
must have been the language of God in the Garden, that is if 
language then, was really sound of tongue and notmere signs, 
or inarticulate sounds. After the dispersion, men's tongues 
became confused; mankind multiplied, and through numerous 
individualizations, types of particular men or communities, 
became narrowed, the more peculiarization of types, the 
narrower became each of them. These allusions to speech 
in beasts are handed down to us through the Hebraic tongue, 
a race which has maintained its purity of type free, from the 
time of the Christ we know in our Christian era. The Christ 
was a Jew. While the God of the Hebrew, his Father, 
spake to the serpent in the oldest language, the Mayan 
tongue, Christ, his Son, spoke to the Jews, in Hebrew. 
These two languages then, so widely separated by time, 
are the only ones inspired of God in this Christian- Jewish- 
Greek religious world of other days. 

Dr. Brinton, in his ethnological and philological studies 



180 



Albert S. Ashmead. 



in Yucatan and Central American civilization, and whose 
manuscript dictionaries of the Maya language are the finest 
in the anthropological world, has deciphered among the 
Mayan tribe, a Mayan origin for the last words of Christ 
on the cross "Eli, Eli, Lama, Sabach thani," which, inter- 
preted not in Hebrew as most theologians do, as "My God, 
My God, why hast thou forsaken me?" but in Mayan, as 
"it is dark, it is dark, this must be death;" or "there is 
no light" is a much purer interpretation of the last words of 
the Son of God, (which naturally would be in his Father's 
tongue) than is a lament that his Father had deserted him 
in his supremest hour. 

All knowledge came to us from the tree of knowledge 
of good and evil. Some of our knowledge we call good ac- 
cording to the light or power of interpretation that is in us, 
at a certain period of world existence; some we call evil, 
according to our lesser capacity, or necessity of judgment, 
of education, of environment, or lack of power to be "good," 
in one country or another, or race, or under one or another 
religious bringing up, circumstances of life, over which we 
have no more control than we do over the question of birth. 

Now Mayan, in Hindostan, means the personified active 
will of the Creator. This allusion is personified as a Ce- 
lestial Maiden (woman) taking the place of the older Avidya 
or Nescience. 

Avidya is Sanscrit and means ignorance, which is 
''Maya" the condition in which every one must be at birth, 
and remain until he "eat" of the fruit of the tree of 
knowledge of Good and Evil. 

According to the dictionary, philosophical nescience re- 
gards the mind or soul as cognizable only as successive 
states of consciousness and with no ultimate ideas of its 
own. Cosmological nescience denies or ignores the exist- 
ence of soul, matter, and God, — one or all. Ontological 
nescience denies that anything can be known in itself. 
There may even be distinct degrees of nescience, as (1) 
that nothing is knowable beyond cogitation; (2) that noth- 
ing is knowable beyond the cogitative Ego; (3) that if any- 
thing is knowable beyond that, it cannot be known with 



Man* s Moral Evolution. 



181 



certainty. In all forms, nescience may be positive or neg- 
ative. 

In David Grieve Mrs. Humphrey Ward says: The new 
English phase Kantian and Hegelian thought is the outlet 
of men who can neither hand themselves over to authority 
like Newman, nor to a scientific materialist like Clifford 
and Haeckel, nor to a more patient nescience in the sphere 
of metaphysics like Herbert Spencer. Bacon says: "We do 
not meditate or propose a catalepsy, but en- catalepsy, for 
we do not derogate from sense, but help it, and we do not 
despise the understanding but direct it," 

Acatalepsy is the incomprehensibleness of things; the 
doctrine of the ancient skeptics, that things are such that 
no certain knowledge of them is possible. 

Agnosticism was the creed of a sect of the 3d century, 
who held that God does not know all things. In general, 
the doctrine was of nescience, or that theory of knowledge 
which maintains that man cannot have, or at least has not 
any real or absolute knowledge of anything, but can know 
only "impressions." Contemplated in its philosophical side 
agnosticism is a professed exposition of the limits of human 
knowledge and thought, maintaining the impossibility of 
knowledge of the Infinite, in opposition to the theory of a 
restricted but true knowledge of the First Cause, as infinite 
and absolute. (Relig. Encyclop.) 

Epistemology is the theory of the grounds of knowledge. 

Experimentalism is the theory that all knowledge is 
based on and must be tested by sense and experience as 
distinguished from intuition: opposed to intuitionalism. 

Gnosiology is the branch of philosophy that treats of 
the principles of cognition; the theory of knowledge or of 
the philosophic principles underlying knowledge, or the 
activities of the cognitive faculties. Gnosis means the 
higher knowledge of mysteries. Gnosticism was an eclectic 
system of religion, and philosophy existing from the 1st to 
the 6th century. It occupied a middle ground between 
paganism and Christianity; teaching that knowledge rather 
than faith or philosophy was the key to salvation; and in- 



182 



Albert S. Ashmead. 



corporating some of the features af Platonism, Orientalism 
and Dualism with Christianity. The Gnostics held that all 
existences, material and spiritual, are derived from the 
Deity, by successive emanations or eons. Christ was merely 
a superior eon. Eon is the personification of a divine at- 
tribute, especially one of the higher class of emanations 
from the deity whose substantial powers, embraced in the 
divine essence, constituted the divine plenitude or pleroma. 
The pleroma consisted of God, (silence or conception,) from 
which emanated pairs in a downward scale, mind, truth, 
word and life, man, church. With eleven other pairs, these 
constitute the divine pleroma or fulness. These beings are 
called Eons. (Relig. Encyclop.) 

Intuition is quick perception of truth without conscious 
attention or reasoning, or the possession of such perception; 
knowledge from within, instinctive knowledge or feeling. 
Genius works less by a process of conscious reasoning, 
than by a flash of intuition, and less by abstract concep- 
tion, than by a prophetic beholding of results. (Poetry 
and Duty, Imagination.) 

In psychology, intuition is the power of gaining im- 
mediate knowledge whether by sense-perception, by con- 
sciousness, or by rational apprehension; especially the 
power of gaining such knowledge of necessary truths. In 
philosophy intuition is any immediate knowledge, espe- 
cially the knowledge of the first or necessary truths or 
principles underlying all other and mediate knowledge. 

Intuitionalism is that general system of philosophy in 
which the immediate perception of truth, and especially of 
necessary truth, is recognized as an original endowment of 
the intellect and as the foundation of all knowledge. 

Dr. McCosh, of Princeton, suggested the term Mero- 
gnostic for one who claims to know in part as distinguished 
from gnostic and agnostic. Joseph Cook says it is not true 
that we know everything. Nor is it true that we know 
nothing. It is true that we know in part. Between gnos- 
ticism and agnosticism stands the sound philosophy of 
mero-gnosticism. A cautious and well-informed man will 
be neither gnostic nor agnostic, but a mero-gnostic. 



Man's Moral Evolution. 



183 



Metagnosticism is the doctrine that there is a positive 
knowledge of the absolute attained, not by the logical 
reason, but by a higher religious consciousness, introduced 
in opposition to the negation of agnosticism. Metagnostics, 
imply a metaphysics, a going beyond ordinary knowledge. 

Skepticism is the doubt, or entertainment of a doubt 
concerning: something. It is the state of being a skeptic 
or the doctrines of skeptics. An attitude of doubt towards 
the doctrines of historical religions is called skepticism. It 
implies doubt concerning all propositions whatever. 

Pyrrhonism was a system of gnosiology inculcating 
skepticism, taught by Pyrrho about 360 — 270 B. C. He 
was the founder of the first and inspirer of the second 
skeptical schools of Greek philosophy — hence absolute skep- 
ticism. Pyrrhonism affirms that both the senses and con- 
sciousness as sources of knowledge are absolutely untrust- 
worthy, and that just as much can be said against the 
truth of any opinion whatever as in favor of it, and it ad- 
vocated holding the judgment in permanent suspense on all 
subjects. 

Mysticism implies obscurity, mysteriousness. In gnosi- 
ology it is the doctrine that truth is attainable without the 
aid of the senses and the processes of thought or reason. 

Mysticism, according to Morell, (Speculative Philosophy) 
is that which refusing to admit that we can gain truth with 
absolute certainty either from sense or reason, points us to 
faith feeling, or inspiration, as the only valid source. 

Mysticism is the doctrine and belief that man may 
attain to an immediate direct consciousness or knowledge 
of God, as the real and absolute principle of all truth and 
of all essential divine truth in him. The term is applied to 
a system of thought and life of which the chief feature is 
an extreme development of meditative and intuitive meth- 
ods, as distinguished from the definitive and scholastic. It 
takes different forms as it maintains that truth is gained (1) 
by a mode of faith or of intuition as held by Coleridge, 
Thos. Taylor, Bronson Alcott and others; (2) by a fixed 
supernatural channel, as the Bible, the church, or the sacra- 
ments; (3) by extraordinary supernatural means, as by the 



184 



Albert S. Ashmead. 



immediate action of God upon the mind, as maintained by 
Friends, Quietists, etc. 

Philosophers and Monks alike employ the word mys- 
ticism and its cognate terms as involving the idea, not 
merely of initiation into something hidden, but, beyond this, 
of an internal manifestation of the Divine to the intuition 
or in the feeling of the secluded soul (Hours with the 
Mystics) . 

Quietism is the doctrine that spiritual exaltation is at- 
tained by self-abnegation, and withdrawing of the soul from 
outward activities; fixing it on passive religious contempla- 
tion ; mystic meditation or introspection, as cultivated by the 
Molinists, or by Buddhists. 

Miguel de Molinos, a Spanish priest of the 17th cen- 
tury, was the expounder of this system. As the Hindus 
steadily pressed down the valley of the Ganges, into warmer 
regions, their love of repose and contemplative quietism, 
would continually deepen (The Two Faiths). Hence its 
origin or continuance in Brahminism and Buddhism. The 
modern school of Nescientists maintain that it is not com- 
petent for the finite intelligence to ascribe motives to the 
unknowable (Science and Religion). 

Experience is knowledge derived from proof furnished by 
one's own faculties or senses; experimental knowledge, 
especially the state of such knowledge in an individual as 
an index of wisdom or skill. 

In the associationist or experimentalist philosophy, it is 
the immediate perception of simple or historical fact, espe- 
cially perception of the senses, excluding perception of the 
necessary relations of fact and intuitive truths, the exist- 
ence of this mode of perception being denied. The process 
(and the power) of inductive observation and conclusion, 
especially as resulting practical wisdom. 

Faith is a firm conviction of the truth of what is de- 
clared by another by way either of testimony or authority 
without other evidence; belief in what another states, affirms 
or testifies, simply on the ground of his truth or veracity 
(especially as distinguished from mere belief), practical de- 
pendence on a person, statement or thing as trustworthy — 



Man's Moral Evolution. 



185 



fiducial as opposed to merely intellectual belief — trust. 

In theology specifically (1) the assent of the mind or 
understanding to the truth of what God has revealed; be- 
lief in the testimony of God as contained in the Scriptures; 
(2) a divinely wrought, loving and hearty reliance upon 
God, and his promise of salvation through Christ or upon 
the Christian religion, as revealing the grace of God, in 
Christ; sometimes calle i justifying or saving faith, as we 
are saved through faith. The first conscious exercise of the 
renewed soul is faith. (Systematic Theology.) 

More widely it is operative belief in the truths of re- 
ligion; practical realization of the power and excellence of 
Christian doctrine; as a serene and blessed faith. Intel- 
lectual conviction in general on whatever based, including 
even an approach to absolute knowledge; faith in Herodotus; 
faith in the nebular hypothesis; faith in mathematical demon- 
stration or axiom; a doctrine or system of doctrine, or a 
proposition or set of propositions, that one holds to be true; 
specifically a religious creed or article of belief, as the 
Lutheran faith, a man's political faith. 

Thackeray says in Henry Esmond: " 'Tis not the dy- 
ing for a faith, that's so hard, Master Harry, 'tis the living 
up to it, that is difficult." 

In religion it is common to distinguish between intel- 
lectual belief of religious truth, as any other truth might be 
believed, and belief of the heart, or saving faith. 

The Latin word "fido" from which faith comes, means 
trust. 

Le Plongeon says of Yucatan: "One-third of the Mayan 
tongue is pure Greek. Who brought the dialect of Homer 
to America? Or who took to Greece that of .the Mayas? 
Greek is the offspring of the Sanscrit. Is Maya? Or are 
they co-eval? The Maya is not devoid of words from the 
Assyrian." According to Dr. Max Muller, if we confine 
ourselves to the Asiatic continent, with its important penin- 
sula of Europe, we find in that vast desert of drifting hu- 
man speech three, and only three oases, have been formed 
in which, before the beginning of all history, language be- 
came permanent and traditional — assumed in fact a new 



186 



Albert S. Ashmead. 



character, a character totally different from the original 
character of the floating and constantly varying speech of 
human beings. These three oases of language are known 
by the name of Turanian, Aryan and Semitic. In these 
three centres, more particularly in the Aryan and Semitic, 
language ceased to be natural; its growth was arrested, 
and it became permanent, solid, petrified, or if you like, 
historical speech. I have always maintained that this cen- 
tralization and traditional conservation of language could 
only have been the result of religious and political influ- 
ences; and I now mean to show that we really have clear 
evidence of three independent settlements of religion, the 
Turanian, and Aryan and the Semitic — concomitantly with 
the three great settlements of language. There can be no 
doubt that the Aryan and another branch, which Muller 
called Semitic, but which may more properly be called Ham- 
ite, radiated from Noah; it is a question yet to be decided 
whether the Turanian or Mongolian is also a branch of the 
Noachic or Mayan stock. 

Max Muller says further: If it can only be proved that 
the religions of the Aryan nations are united by the same 
bonds of real relationship which have enabled us to treat their 
languages as so many varieties of the same type, and so 
also of the Semitic, the field thus opened is vast enough 
and its careful clearing and cultivation will occupy several 
generations of scholars. Names of the principal deities, 
words, also expressions of the most essential elements of 
religion, such as prayer, sacrifice, altar, Spirit, law and 
faith, have been preserved among the Aryan and among 
the Semitic nations; and these relics admit of one expla- 
nation only. After that a comparative study of the Tura- 
nian religions may be approached with better hope of suc- 
cess; for that there was not only a primitive Aryan and a 
primitive Semitic religion, but likewise a primitive Tura- 
nian religion, before each of these primeval races was broken 
up, and became separated in language, worship and national 
sentiment, admits, I believe, of little doubt. There was a 
period during which the ancestors of the Semitic family had 
not yet been divided whether in language or religion. That 



Man's Moral Evolution. 



187 



period transcends the recollection of every one of the Semitic 
races, in the same way as neither Hindoos, Greeks nor 
Romans have any recollection of the time when they spoke 
a common language and worshipped their Father in heaven 
by a name that was as yet neither Sanscrit nor Greek, 
nor Latin. But I do not hesitate to call this prehistoric period 
historical in the best sense of the word. It was a real 
period, because, unless it was real, all the realities of the 
Semitic languages and the Semitic religions, such as we find 
them after their separation, would be unintelligible. Hebrew, 
Syriac, and Arabic point to a common source as much as 
Sanscrit, Greek and Latin; and unless we can bring our- 
selves to doubt that the Hindoos, the Greeks the Ro- 
mans, and the Teutons derived the worship of their 
principal deity from their common Aryan sanctuary, we shall 
not be able to deny that there was likewise a primitive 
religion of the whole Semitic race, and that El, the strong 
one in heaven, was invoked by the ancestors of all the 
Semitic races before there were Babylonians in Babylon, 
Phoenicians in Sidon and Tyre — before there were Jews in 
Mesopotamia or Jerusalem. The evidence of the Semitic is 
the same as that of the Aryan language; the conclusion 
cannot be different. 

These three classes of religion are not to be mistaken — 
as little as the three classes of language, the Turanian, the 
Semitic and the Aryan. They make three events in the 
most ancient history of the world; events which have de- 
termined the whole fate of the human race, and of which 
we ourselves still feel the consequences in our language, in 
our thought, and in our religion. 

''The original seat of the Phoenician Hebrew family is 
supposed by some to have been in the Central American 
situation. The Great God of the so-called Semites was El, 
the Strong One, from whose name comes the biblical 
Beth-el ("house of God"), Ha-el ("the Strong One"), 
El-ohim ("the God"), El-oah ("God"); and the Arabian 
names of God, Allah and Ba-bel. The Tower of Babel was 
the Tower of God. 

The original "language" of the earth was Mayan (ig- 



188 



Albert S. Ashmead. 



norance), from which grew all human expressions of intel- 
ligence, either by growth of language, by words of speech, 
or pictorial signs, and with these expansions, have come to 
us, all our conceptions, intellectual or moral, of whatever 
has been, is, or will be. Muller says that Ignorance (Maya- 
Avidya) is really the primary cause of all that seems to 
exist. 

Death, then, is the blotting out of all the individual's 
knowledge. From Nescience we came, and to Nescience 
we shall return. With knowledge, we acquired conception 
of the fact, of death. 

( To be continued.) 



CASE OF CANINE HERMAPHRODISM. 



BY R. W. SHUFELDT, M. D., 

Major Med. Dept. U. S. Army, (Ret.) Member 'Medico Legal Soc. 
N. Y. City. Cor. Member Zool. Soc. London, etc., etc., etc. 

CJARLY in the month of September, 1906, my attention 
was invited by Dr. Sam'I E. Weber, of Lancaster, 
Pa., to the case of a Boston terrier, then in the wards 
of the New York Veterinary Hospital (117 West 25th 
Street), that presented certain anomalies of the genital 
organs. The animal was owned by a lady in New York 
City, and it was entered as an "out patient case" to be 
cured, if possible, of a persistent and annoying habit. It 
was claimed that the dog was apparently possessed of a 




(Fig. i. Hermaphrodite Dog.) 
very amorous disposition, and when at liberty and brought 
in association with others of its kind, it immediately 
availed itself of the opportunity to gratify its inordinate 
sexual desires upon them, and this quite irrespective of 
the sex of the comers. 

On the 7th of the above mentioned month, in company 
with Doctor Weber, I visited the Veterinary Hospital to 
examine the case. I took with me an 8x10 camera and 

(189) 



190 



R. W. Shufeldt. 



the necessary materials to make photographs if required. 
At the institution in question, Doctor Armstrong was the 
surgeon in charge, and through his courtesy every possible 
facility was extended to me to make as full a record of the 
case as one could desire. It was soon ascertained that the 
animal under observation was of the breed known as the 
Boston terrier, and one not quite two years old. (See 
Figure 1). There was nothing peculiar about it upon 
superficial examination; confiding in its behavior and gentle 
in disposition, it resembled most other dogs of its kind that 
I had seen. Moreover, the color of its coat resembled what 
we see in most of the breed, being of a general smoky 
brown, with white paws, a white medium frontal stripe 
and collar, with white encircling the entire muzzle including 
the anterior part of the lower jaw. Its tail and ears had 
been cropped, and it was in excellent general health. 

Proceeding to the examination, in which Doctors Weber 
and Armstrong took part, it was demonstrated that the 
genital fissure in this animal was unusually small for a 
subject of its age and size. On the other hand the vaginal 
labia were prominent, puffy, and somewhat enlarged. They 
were likewise to a degree congested and exhibited evidences 
of undue excitation. What was more remarkable than 
anything else however, was the anatomy of the clitoris. 
Here we were presented with a structure, which for size 
and peculiarities, exceeded anything of the kind I had ever 
witnessed in a canine. It was not only voluminous in 
proportions, but upon the slightest provocation it became 
erect, at which time it measured fully two centimetres or 
more in length and harbored in its central medium longi- 
tudinal structure a firm, dense morphilogical element that 
was either composed of true bone or else was composed of 
a corresponding cartilaginous constituent homologous with the 



Canine Hermaphrodism. 



191 



os penis as found among the Canidce generally. Through 
the kindness of Doctor Weber and an assistant, I was 
enabled to photograph this structure, and a print from the 
resulting negative is herewith reproduced in Figure 2. 

This large clitoris was semi-erect when photographed, 




(Fig. 2. External genitals in a Hermaphrodite Dog.) 

and we all being on the roof of the hospital at the time, 
there was a strong overhead light, and this accounts 
for the deep shadow beneath and in continuation with the 
structure. 



192 



R. W. Shu/eldt. 



As the vagina was of small calibre it was impossible 
to make any satisfactory examination of the internal organs 
of generation, but it is fair to presume that it is quite 
possible they do not depart much from the structures as 
they are found normally. It is fair to imagine that they 
were to some extent aborted. The mammary glands were 
much reduced, and the animal had never littered. 

As this terrier was under my observation less than an 
hour I had no proper opportunity to study the psycho- 
logical side of its nature, something I should very much 
liked to have done. I deem it more than probable that its 
sexual instincts and the methods resorted to, to gratify 
them would, everything else being equal, be quite similar 
to those of a human hemaphrodite with a like abnormality 
of the parts involved. 



IS SEXUAL PERVERSION INSANITY?* 



By HAROLD N. MOYER, M. D., 

Chicago. 

THE problems raised in the title of this paper depend for 
solution on the conception of the two psychic phe- 
nomena mentioned. As all conditions in science being pro- 
ducts of development are relative, no absolute standard can 
be employed. Insanity cannot be a product of education, 
of mental environment or even of strong outside sug- 
gestion. It must be a condition dependent on factors in- 
herent in the individual, not the result of adequate ex- 
ternal causes, and furthermore, must prevent the individual 
from recognizing its morbid nature. The imperative con- 
ception of neurasthenia and allied states, whose morbid na- 
ture is recognized by its victim and whose expression is 
checked by him, is not considered for these reasons insan- 
ity. The first postulate of a scientific conception of insan- 
ity, is therefore, a morbid mental condition, based on brain 
disease, disorder or defect. These three elements represent 
the pathology of all types of insanity, since the patho- 
physiologic basis is either teratologic, as in all the congeni- 
tal types, or circulatory and destitute of demonstrable pa- 
thologic results or, finally, characterized by these last. 
Another element necessary to the conception of insanity is 
that no adequate external cause of mental type shall be 
present. Many strange customs and beliefs, which in a 
civilized 20th century human being suggest insanity, even 
at present are but too often survivals of the folklore of 
primitive man. Less than a quarter of a century ago a 
German and his wife were sentenced to the penitentiary 



* Transactions, Chicago Academy of Medicine, Nov. 1906. 

(193) 



194 



Harold N. Moyer. 



for assaulting a young girl to cure themselves of gonorrhea, 
in accordance with the folklore belief that disease can be 
cured by giving it to another. A little over a decade ago, 
many prominent North Side Germans of Chicago were 
gulled by a "doctor," who professed to cure disease by 
putting money into a magic tree. Some of his dupes, with 
the mixture of suspicion and stupidity so characteristic of 
the superstitious, marked the money given him, and found 
that in lieu of worshiping Dryads, he had been worshiping 
Gambrinus. In consequence, he was sent to the peni- 
tentiary for obtaining money under false pretenses. An 
element necessary to the conception of sanity is that the 
balance of the will, however disturbed, shall not be de- 
stroyed and that the individual shall be able to control as 
well as recognize the expression and results of his morbid 
condition. 

Sexual perversion is an alteration of the normal sexual 
appetite, either as to the object of the appetite, or as to 
the method of its expression. This may occur in accord- 
ance with the ordinary physiologic law that a nerve too 
frequently excited by one irritant, ceases to respond to that 
irritant and requires a new excitant. In sexual perversion 
therefore occur conditions where the state is fully recog- 
nized and new excitants are consciously and willingly em- 
ployed to rouse a fading passion. Sexual perversions may 
therefore be divided, as they affect the expression or the 
object into sexual perversion, which dominates the expres- 
sion; inversions which dominate the object and perversi- 
ties, where the method of excitation is voluntarily used to 
rouse a sated appetite. The perversions include what 
Havelock Ellist has called erotic symbolism, usually desig- 
nated fetichisms. This may affect methods of conjugation. 
The primitive appetite was hunger and sexuality first ex- 
pressed itself in the cannibalistic conjugation of the 
ameba. This creates a condition, where pain inflicted or 
suffered as an expression of affection, is an essential part 
of conjugation. In accordance with the ordinary law of 
psychic evolution, the symbol takes the place of the thing 



\Mcdicine. 1906. Alienist and Neurologist, 1906. 



Is Sexual Perversion Insanity? 



195 



symbolized. Here, as in the allied domain of religious emo- 
tion, the symbol often becomes all important to enjoyment. 
In this state the individual may fully recognize the signifi- 
cance of his acts, may be fully able to restrain them, but 
still prefers the enjoyment given by them. The two con- 
ditions coming under this category are variously designated 
as active and passive algophily, active and passive algo- 
lagnia, sadism and masochism. These erotic symbolisms 
may take a normal (hetero-sexual) direction or an inverted 
(homo-sexual) direction. The inverted type may be an 
expression of arrested development at the indifferent period 
of intra-uterine life, whereby the nervous system takes one 
ply while the sexual organs take another; still the individ- 
ual recognizes the same general moral code and can 
comply with it as easily as the ordinary well -developed 
human being. He recognizes that, however different from 
others, his sexual expressions are still sexual expressions, 
and must for moral considerations have the same limitation 
as those of normal appetite. In addition to the classifica- 
tions just given, others worthy of mention occur in the lit- 
erature. J. G. Kiernan* classified perversions as: Those 
which originate in imperative conceptions. Those due to 
congenital defect. Those which are incident to insanity, 
periods of involution, or to neurotic states. Those which 
result from vice. These last arise from the fact that nerves 
too frequently irritated by a given stimulus require a new 
stimulus to rouse them. Those who have a neuropathic 
diathesis and whose sexual functions are not normally per- 
formed. 

G. Frank Lydstont classifies them thus: 

Congenital and perhaps hereditary sexual perversion. 

Acquired sexual perversion. 

a. Sexual perversion without structural defect of the 
sexual organs. 

b. Sexual perversion with defect of genital structure, 
e. g., hermaphroditism. 

c. Sexual perversion with obvious cerebral defect, like 
idiocy. 



*Detroit Lancet, 1884. 
fEssays: 1889. 



196 



Harold N. Moyer. 



a. Sexual perversion from pregnancy, the menopause, 
ovarian disease, hysteria, etc. 

b. Sexual perversion from acquired cerebral disease, 
with or without recognized insanity. 

c. Sexual perversion (?) from vice. 

d. Sexual perversion from over-stimulation of the 
nerves of sexual sensibility and the receptive sexual 
centres incidental to sexual excesses and masturbation. 

Krafft-Ebing* divides the abnormal manifestations of 

the sexual appetite into: 

Peripheral Neuroses 
Spinal Neuroses 



Cerebral Neuroses, 
f Anasthesiae 



Sensory \ 



Motor \ 

I 

Secretory | 

Erection 
Ejaculation 
Paradoxal 
Anaesthetic 
Hyperses- 

thetic 



Hyperathesiae 
Neuralgise 
Nymphomania 
Satyriasis. 

Spasms 
Pollutions 
Paralysis 
Spermatorrhea. 

Aspermia 
Polyspermia. 

Disorders 
Disorders 
Neuroses 
Neuroses 

Neuroses. 



Aberrant 
but normal 
appetite. 



Diminution 
or abolition 
of normal 
appetite. 



f Sadism 
] Masochism 
1 Fetichism 
I Necrophilism 

f Congenital 
| sexual per- 
! version. 
! Acquired 
[ sexual 
I perversion. 



f Psychical hermaphroditism or hetero- 
I sexuals. 

Sexual perversion proper \ Pure homosexuals. 

j Effemination or viragininity. 

L Gynandry and androgyny. 

According to Sommers, the endogenous nature of a 
certain mental state is not sufficient to establish the ex- 
istence of mental disease. This is especially the case in 
the domain of psycho-sexual anomalies. When it is 
proven that a person, from endogenous disposition, is per- 
verse, e. g., when a man is excited (sexually) by another, 
he should be punished for a corresponding act, when the 
act falls within those that are punishable. "Human so- 
ciety has the same right to demand control of the en- 

Tsychopathia Sexualis. 



/s Sexual Perversion Insanity? 



197 



dogenous impulse in general that it has to demand it in 
cases of congenital allo-sexual instinct when it is directed 
against a child of the opposite sex; or that the impulses 
to possess the property of others be repressed. There- 
fore, if these perverts are to be made free from punish- 
ment, this is not to be done during the existence of the 
present laws by declaring them insane, but by changing 
the laws. The decision of this question is not to be made 
by psychiatry, but by public opinion, in so far as it may 
be the expression of the actual moral ideas of the majority 
of the people. As long as the moral ideas of the majority 
of the people are opposed to homosexual acts and the laws 
give expression to these ideas, the so-called contrary sex- 
ual persons must control their impulses, as the man who, 
hungry, must control his impulse to possess himself of the 
property of others. At most, it might be said that the 
gratification of homosexual inclinations was a private mat- 
ter between two persons, which did not harm society as 
long as scandal is not excited by it. There seems to be 
no doubt, however, that among those persons that indulge 
in homosexual acts, there are many insane individuals. The 
mere existence of endogenous anti-social impulses (among 
which those in question are to be reckoned), like en- 
dogenous instincts, should not be punished, but they should 
not be taken as evidence of , insanity." 

Schrenck-Notzing* remarks that there are three possi- 
ble etiologic developmental factors in the production of 
contrary sexual instinct: (1) original cerebral constitution; 

(2) a neuropathic disposition with educational influence; 

(3) puie cultivation in normal individuals. Class 2 is by 
far the most numerous. 

"The fact of disease of the sexual instinct does not in 
itself render the individual affected irresponsible. Only 
the proof that the individual has committed a criminal act 
as a result of organic necessity, as if forced to it, and ow- 
ing to his cerebral constitution, was incapable of developing 
(or acquiring) the necessary inhibitory (or restraining) 
ideas, will allow him to be held as devoid of free will. 



*Psychopathia Sexualie. 



198 



Harold N. Moyer 



Very many individuals of contrary sexuality are well able 
to control their impulses." The broad leniency which Moll 
accords such patients, in this respect, naturally appears to 
Schrenk-Notzing unjustified by the canons of psychiatry, 
or the principles which demand in a given case the com- 
plete exclusion of the alternative hypothesis. Joseph 
Zeissler,* in a discussion before the Academy fifteen 
years ago, took ground with the jurisprudent Hoffman, that 
sexual perversion is an insanity. At the time, Kiernan 
pointed out that Hoffman had not taken into account the 
survivals of racial customs, which made perversion a prod- 
uct of education, nor taken into account the distinction 
between desire and irresistible impulse. The existence of 
mixed cases where mental disorder co-exists with and 
even produces perversions, have occasioned much of the 
differences in opinion. 

The types where the issue of insanity is raised in sex- 
ual perversion, are usually the sadistic or active algo- 
philiac, necrophilism or the hair-cutters. These types have been 
most frequently the subject of judicial determination. Necroph- 
ilism is a symbolism whereby the necrophiliac symbolizes pain 
to secure excitement by desecrating- the dead. The last 
Illinois case of this kind occurred in a paroled inmate of 
the Pontiac penitentiary, aged 18, who desecrated the body 
of a recently buried girl at Danville, in 1901. The crimi- 
nal displayed no other sign of mental disorder, but seemed 
to enjoy the notoriety of the occurrence. The algophiliac 
type is not uncommon in its minor expressions in women 
who are otherwise normal. Indeed, in biology, active algo- 
phillies are found more frequently in the female animal 
than in the male. The active algophily of the queen bee, 
so charmingly described by Maeterlinckt and the algophily 
to which Emerson! compares introspection: As 

That demon spider that devours her mate, 

Scarce freed from her embraces, 

are instances of this. In certain hermaphroditic snails the 



* Alienist and Neurologist, 1891. 
fLife of the Bee. 
tPoems. 



Is Sexual Perversion Insanity? 



199 



ejection of a limy dart (spicula amoris) is a necessary 
preliminary to conjugation. That these conditions should 
crop up in woman inverts, especially those in whom auto- 
erotism has dulled the normal excitability, is not surprising. 
While woman is normally the least anti-social of the 
sexes, she naturally becomes more anti-social than man 
when she departs from her type. 

The case to which I am about to call special atten- 
tion was one of sadism, which occurred in a woman de- 
voted to church society and charity work, the mother of 
children and the seemingly devoted wife of a man of stand- 
ing in the community where she lived. There were defect- 
ives among both the paternal and maternal ancestors. 
Psychic abnormality was far from infrequent. The external 
life was seemingly correct. The criminal episode was one 
apparently at variance with the life previously led by the 
accused. It consisted in the infliction of wounds on a girl 
taken from a Home-finding Society. There were over 200 
wounds inflicted in various fashions; several attacks had 
been made on the genitals and breasts under conditions 
which showed realization at once of the unlawful nature 
of the assault and its voluptuous origin. The girl was, 
moreover, very parsimoniously treated as to food and cloth- 
ing. At the outset, therefore, it must be admitted that 
there are suggestions of insanity. Sadism in women, 
while as pointed out already as exceptional, is not so exces- 
sively rare as might be inferred from the statements on 
the subject. Indeed, under the ordinary laws of reversion it 
must occur among women. Among many species, as Have- 
lock Ellis* points out, wounding and rending normally take 
place at or immediately after coitus; at the beginning of 
animal life in the protozoa, sexual conjugation itself is 
sometimes found to present the similitude, if not the act- 
uality, of the complete devouring of one organism by 
another. Over a very large part of nature, as it has been 
truly said, but a thin veil divides love from death. There is, 
indeed, on the whole, a point of difference. In that ab- 
normal sadism which appears from time to time among: civ 



♦Psychology of Sex. Love and Pain. 



200 



Harold N. Mover 



ilized human beings, it is nearly always the female who 
becomes the victim of the male. But in the normal sad- 
ism, which occurs throughout a large portion of nature, 
it is nearly always the male who is the victim of the fe- 
male. It is the male spider who impregnates the female at 
the risk of his life and sometimes perishes in the attempt; 
it is the male bee who, after intercourse with the queen, 
falls dead from that fatal embrace, leaving her to fling 
aside his entrails and calmly pursue her course. If it seem 
to some that the course of inquiry leads one to contem- 
plate with equanimity, as a natural phenomenon, a certain 
semblance of cruelty in man in his relations with woman, 
they may, if they will, reflect that this phenomenon is but 
a very slight counterpoise to that cruelty which has been 
naturally exerted by the female on the male long even 
before man began to be. 

The history obtainable of the accused, since indict- 
ment, indicates that element of satiety which seeks per- 
vert conditions as a source of new excitation. The ac- 
cused, despite her marital possibilities of sex satisfaction, 
was addicted to masturbation to such a degree as to be- 
lieve it had been noticed, and that sermons had been 
preached at her by the very clergyman who testified to 
her good character. This belief had none of the mental 
characteristics of a delusion, but was the product of intro- 
spection quite common in sane masturbators. She also 
caressed dogs and, acccording to her admissions, these ca- 
resses had extended very far. Penis manipulation of the 
dog preceded coitus. The mental state, as near as could be 
determined, was that of a' desire for a new sensation so 
common in roues, hysterics and sated voluptuaries. The 
girl victim was about fourteen years old at the time she 
was sent to the accused by a Home-finding Society. She 
was given quarters indicating parsimony rather than phi- 
lanthropy in her care. The application sent to the Home- 
finding Society agreed to treat the girl as a member of the 
family, and to clothe her and care for her accordingly. A 
contract was signed to this effect, which was not carried 



Is Sexual Perversion Insanity? 



201 



out despite the wealth of the family. The accused was in 
the habit of running a toasting fork and scissors into the 
girl's body when excited. At times she would strike her 
with a switch or club. The girl's eye at one time was 
blackened by a blow of the accused, who told her husband 
that the girl had run against something. At times she 
used to scratch the girl on her back, neck, face, hips and 
legs. She would throw the girl on the floor, grab at 
the girl's breasts and say she wanted to tear them off. At 
times she would manipulate the genitals, so that the girl 
felt as if everything was being torn out of her body. She 
was careful to have the door locked at such times, and even 
attempted to direct her husband's attention away from any 
incriminating circumstances. Were there any disturbance 
that implied the approach of outsiders, the manipulation, 
stabs, scratches or blows would immediately cease. After 
indictment and before trial the accused was sent to a sani- 
tarium, where she is said to have presented manic-depres- 
sive-insanity. This was not shown in the trial nor in the 
period immediately following it, nor at the second trial and 
proved undetectable to the superintendent of the State in- 
sane hosp.tal, to which she was sent after the second 
trial. At the first trial, the jury found her guilty and gave 
her a penitentiary sentence. The judge granted a new 
trial, which was held in another county. This resulted in 
the verdict of guilty and sane at the time of assault, and 
a verdict also of having become insane since the assaults. 
There was no evidence of insanity in the acts themselves, 
and they clearly demonstrated a full knowledge of the nature of 
the act, as well as full power to refrain. The testimony as 
to good character offset any evidence as to insanity at 
the time and before the acts alleged. This testimony was 
as to the standing in church, society and philanthropic 
work by people who were in frequent communication with 
the accused, but who failed to recognize any mental defect. The 
case presents some parallelism with that of Mrs. Brownrigg.* 
In her case, however, while there was equal cruelty, also seem- 
ingly of a voluptuous character, there was more parsimony. 

♦Remarkable Trials. 



202 



Harold N. Mover. 



Cruelty to servants was not then viewed with public dis- 
approval. Mrs. Brownrigg took two girls from the Found- 
ling hospital, who at first were treated with some degree 
of consideration and attention, but as soon as they became 
familiar with their mistress and their situation, the slight- 
est inattention was sufficient to call down upon them the 
most severe chastisement. The first girl who experienced 
this brutal treatment upon the smallest possible seeming 
provocation, Mrs. Brownrigg would lay across two 
chairs in the kitchen and then whip her, until compelled 
from mere weariness to desist. The mistress would then 
throw water over the victim, or dip her head into a bucket 
of water, and then dismiss her to her ow n apartment. 
The room appointed for the girl to sleep in adjoined the 
passage leading to the street door; after she had suffered 
this maltreatment for a considerable time, as she had re- 
ceived many wounds on the head, shoulders and various 
parts of the body, the other girl was similarly treated. 
One day having been stripped to the skin, she was kept 
naked during the whole day, and repeatedly beaten with 
the butt end of a whip. In the course of this barbarous 
conduct, Mrs. Brownrigg fastened a jack-chain round her 
neck so tight as almost to strangle her, and confined by 
its means to the yard-door in order to prevent her escape, 
so that in case of her mistress' strength reviving she 
could renew the severities which she was inflicting. A day 
passed in the exercise of these most atrocious cruelties, 
the miserable girl was remanded to her cellar, her hands 
being tied behind her, and the chain being still around her 
neck, to be ready for a renewal of the cruelties on the 
following day. Determined then upon pursuing the 
wretched girl still further, Mrs. Brownrigg tied her hands 
together with a cord and, fixing a rope to her wrists, drew 
her up to a water-pipe which ran across the kitchen ceil- 
ing, and commenced a most unmerciful castisation. The 
pipe giving way in the midst of it, she made her husband 
fix a hook in the beam and, then again hoisting up her 
miserable victim, she horsewhipped her until she was 
weary, the blood flowing at nearly every stroke. Nor was 



Is Sexual Perversion Insanity? 



203 



Mrs. Brownri^g the only tormentor of this wretched being. 
Her elder son having one day ordered the girl to put up a 
bedstead, her strength was so far gone that she was un- 
able to obey him, for which he whipped her until she sank 
insensible under the lash. At length the unhappy girl, be- 
ing unable any longer to bear these unheard of cruelties, com- 
plained to a French lady lodger, who appealed to Mrs. Brown- 
rigg. The only result was a volley of abuse at the person who 
interposed, and an attempt to cut out the tongue of her 
apprentice with a pair of scissors, in the course of which 
she wounded her in two places. The girl was rescued and 
taken to a workhouse, where she was found to be in a 
most wretched state, and succumbed soon after. Her body 
was covered with ulcerated sores: and in taking off her 
leathern bodice, it stuck so fast to her wounds that 
she shrieked with the pain. On necropsy the vagina was 
found badly torn and the uterus dragged out of place. 
Similar manipulations had been practiced on the other girl. 
Mrs. Brownrigg was found guilty of murder and executed. 

In this case the old idea of the ownership of servants 
played a part in inducing- a defiance of humane remon- 
strance, which would not have in the early 19th century 
the same significance it does now. Taking all the circum- 
stances of the first case into account, it demonstrates that 
sexual perversion per se cannot be considered insanity. 

In the discussion, G. F. Butler said he had under- 
stood nymphomaniac offers had been made to physicians 
by the Illinois accused woman. J. G. Kiernan said these 
were simply harlot offers to take medical bills out in 
"trade, " showing a mental state not exceptionally rare in 
inverts, with regards to normal indulgence. 

Emory Lanphear, of St. Louis, had noticed that many 
perverts, noticeably exhibitionists, brought face to face with 
the legal significance of their acts and not shown too much 
sympathy as irresponsibilities, could control themselves. 
He believed with E. C. Spitzka,* that all the sexual per- 
versities existed at times in persons of indubitable sanity. 



* Journal of Nervous and Mental Diseases, 1888. 



204 



Harald N> Mover. 



He had under care a case of sadistic fetichism in a 
woman. She had learned masturbation in a convent. She 
married but found coitus insufficient to satisfy her. After 
being entered by her husband she was simply excited and 
had to arise, catch and caress a chicken, and finally wring 
its neck ere orgasm could occur. 

J. G. Kiernan said he had for years held that per- 
version per se was no evidence of insanity.* He thought 
sadistic perversions were more common in woman than was 
usually suspected. He had been consulted in the case of 
an Indiana girl, whom neither masturbation nor coitus sat- 
isfied; who enjoyed canine copulation after the dog's 
penis had been first manipulated, then osculated, then cun- 
nilinctus done by it, then the dog was beaten. She per- 
verted another girl into tribadism and canine copulation, 
but the last had to precede the tribadism with her. The 
woman in the case cited by Dr, Moyer showed traces of a 
similar association of ideas. 

W. G. Stearns agreed with Dr. Moyer that sexual 
perversion per se was not insanity. Erotic fetichism of the 
sadistic type took many quaint forms. A patient under his 
observation had masturbated to excess and copulated 
freely. He desired to see his wife delivered of a child, 
and felt the sight would be intensely voluptuous. Later, the 
idea became dominant, and he was impotent without it. 
He was able to be present at many deliveries. He enjoyed 
most volupty at the delivery of a primipara, where the 
suffering was greatest. 



^Detroit Lancet, 1884. 



EROTISM (NORMAL AND MORBID) AND THE 
UNWRITTEN LAW IN OUR COURTS. 



By CHAS. H. HUGHES, M. D., 

St. Louis. 

THE Unwritten Law, upon which our legal brethren seek 
to secure acquittal for the killing of adulterers, often en- 
ticed into improper sexual relations through the siren seductions 
of confessed adulteresses, as well as without such entice- 
ment, is not founded on any psychic law of justice and 
absolution for the woman. The wiles of women are quite 
equal in seductive power and quite as freely, frequently 
and adroitly exercised for the betrayal of men, as the 
blandishments and promises of men are toward women. 
The sex is not sinless and psychological science can not 
so declare. 

The power of inhibition of appetite has not been 
stronger in men than in women since the apple episode in 
the garden. There woman took the initiative and she has 
done so a good deal in that direction since, though she 
assumes otherwise, through a naivete which the persisting 
adulteress does not actually possess. 

Minds of men moved to extenuate or acquit the mur- 
derer on the confession of a voluntary mistress, not the 
victim of masculine violence, do not act under the sway of 
normal emotion, nor of stable cold reason, but of erotic 
prejudice against their own and of over-leniency 
towards the opposite sex. The true psychologist 
could not sanction such psychically unjust verdicts 
of this nature as are now becoming too frequent 
under the so-called unwritten law, which is non-existent 

( 205 ) 



206 



Charles H. Hughes. 



as municipal and not correct as psychological law, or the right 
law of cerebro- mental conclusion. 

Twelve tender-hearted men in a jury box, themselves 
under the subconscious sway of a woman's silent, erotic 
power at the time perhaps, and the lawyer's vivid, eloquent 
portrayal of a ruined home to which the probably seduced 
seducer has gone, under passion fanned to resistless im- 
pulse, and to which the feminine seducer has willingly 
contributed as particeps criminis, sometimes confessing the 
same, condemn the man, acquit the slayer and let the 
often equal and associate criminal female go free, and think 
it a righteous and logical decision. 

In ancient heathen mythological conception, the Gor- 
gons, as well as the Sirens, were not engaged in conferring 
benefit on mankind, and they have not yet in reality all 
been metamorphozed into saints and angels of goodness to- 
ward mankind or toward themselves. 

Juries of mere men in the goodness of their hearts, the 
erotic hypnotism of their own better home influence, are apt 
at times to forget the psychological truth that evil mingles 
with the good in the female mind and heart, as it does in 
working the eroto mental machinery of masculine mortals. 

Some mythologist doubted if the mythical Gorgons 
could have been women. The psychic neurones and blood 
of these mythologists must have been transmitted to some 
of our weak-minded American juries, if some of their fool- 
ish verdicts in certain erotically inspired murders by women 
and women-impelled men, may be taken as a basis for 
diagnosis. The three vicious sisters: illicit love, jeal- 
ousy and love revenge, or woman spurned and love turned 
to hate in man or woman, have done much harm in this 
world, in and without courts of justice. 

As an illustration of woman's sometime influence and 
indifference to the fate of her lovers at times, the fol- 
lowing may be noted: 

As the result of a duel fought at Wharton, New Jersey, 
lately, over Rosa Latzsky, an 18-year-old Hungarian girl, 
who told her suitors they would have to fight for her, 



The Unwritten Law in Our Courts. 



207 



Henry Waldee is in the hospital in a badly damaged con- 
dition. 

Rosa helped to arrange the duel, which was to take 
place with clubs, in the presence of no witnesses save Rosa 
and a young man, whom she asked to accompany her to 
the place. She watched her admirers cudgel each other 
with their clubs until neither could stand, when she de- 
parted with her other friend, and they were married by a 
justice of the peace. 

The duellists were found later by mine employes, both 
unconscious, and Waldee so badly bruised that he was 
brought to the hospital. 

A similar indifference, to masculine fate and erotic se- 
lection, on the "go it husband; go it bear" principle, may be 
seen any fine day in a barn yard, in the relation of the hens of 
the family towards two fighting cocks engaged in combat and 
subsequently by assent, if not by mutual consent. 

Women who confess to adultery to their husbands do 
not usually make confession till they have become con- 
vinced that they have by plausible statement, that is plaus- 
ible to the husband, freed themselves from blame in the 
mind of the husband. Some do so recklessly, as they may 
have entered into the adultery, or from remorse or pique 
and vengefulness at not getting the appreciation or reward 
sought or happiness expected, especially financial, as hap- 
pened in one case in Missouri, where revelation of illicit 
relations followed a failure of compliance for satisfactory finan- 
cial recompense demanded and threat of exposure, re- 
suiting in the duped cuccolded husband killing the adulterer, 
when the woman herself had been the seducer. 

Confessing his persuasive and magnificent personality, 
they may call the man whom they have helped in the mutual 
seduction, a brute, a blackguard or other vile epithet, and 
profit from the jealousy excited, even though it may lead 
the confiding husband to later insanity or murder of the 
adulterer, wife and suicide. 

Women are frail, uncertain and coy, as the poet has 
written. They are likewise true, faithful and reliable. But 



208 



Charles H. Hughes. 



they are not all to be considered as innocent, stable and 
true. Infidelity is not exclusively a masculine trait, and 
when uxoriously inspired murderous tragedy occurs, be- 
cause of adultery, it were well if justice were not some- 
times so erotically illusioned as to see only a feminine angel 
wronged ("ruined," as the attorney phrases it) by a lecher- 
ous fiend in human form, who has met with just retribu- 
tion at the hands of an avenging masculine angel, though 
he, himself, may not have been without the sin of neglect 
or connivance that may have led the unsuspecting, weak 
and too confiding victim to untimely unwarranted slaughter. 

Men may be weak and impure; women may be weak 
and impure in their erotic spheres of action. The erot- 
ically blind lead the blind and both fall into the ditch to- 
gether, often. Juries are likewise often weak, and when 
there is a woman in the case, they may be erotically 
blinded by the radiant emotion of subjective beauty and 
domestic joy and peace shining in their own hearts, re- 
flected from their own homes of wifely fidelity and see as 
through a smoked glass only the dark images of the 
stealthy, ruthless, lecherous destroyer of the fancied peace 
of another's home, imagined to be only like unto their sacred, 
happy abodes, but for the ruthless, resistless intrusion of the 
home-destroying, domestic peace-blasting, happiness-killing 
adulterer, who ought to be and was righteously shot upon the 
spot, law or no law of man's contrivance to the contrary not- 
withstanding, for in the will of the great Jehovah, the 
work of the fatal bullet, as in the mind of the para- 
noid, if not paranoiac, Thaw, was, in the view of some, the 
will and way of God. 

Violent, passionate emotion, not induced by over- 
mastering disease, even though it leads to murder, is not 
essentially insanity. Emotion and passion, though they 
often go together, are normal qualities of mind and brain. 
Disease of brain, exciting abnormal emotion or impelling 
otherwise unaccountable or unjustifiable passion and con- 
duct must exist to constitute emotional or other form of 
insanity. A brain and mind disordering congestion or other 
brain disorder must exist to impel beyond the normal re- 



The Unwritten Law in Our Courts, 



209 



straint powers of the will, to constitute insanity that exten- 
uates or excuses crime. 

Juries often divide or agree and decide under the 
varying influences of strong emotion. They sometimes de- 
cide against the law and the evidence and the instructions 
of the court, from emotional influence, as well as prejudice 
or favoritism. The true criterion, therefore, for guaging re- 
sponsibility in a case of homicide, where the unwritten law 
of so-called justifiable vengeance has been appealed to and ex- 
ecuted in reckless anger for a real or supposed injury, should 
be — did disease of brain and not passion for vengeance, so 
impel the mind, its governing disturbing creature under dis- 
ease, as to make the deed irresistible. Was the act the 
result of a whirlwind or cyclone of unrestrainable violence, 
because of resistlessly morbid impelling state of brain, ab- 
solutely beyond the control of the normal and to the indi- 
vidual's natural state of mind, even though the diseased 
crime impelling brain had knowledge that the act was 
wrong? New York law to the contrary notwithstanding. 

If a limb is broken, the arm or leg cannot be moved 
aright; if the eye or an ear fail, seeing or hearing is de- 
fective or lost. If the brain and its related mind are dis- 
eased, its functions are not normal and no law made for 
the sane and sound of mind and brain can rightly hold to 
accountability. But impulse and passion, revenge and hate 
and all acts from normal motive are sane acts. All acts 
plainly conformable to motive of gain or passion of what- 
ever kind, are prima facie acts of sanity. However revolting 
and disregardful of moral or lawful propriety they may ap- 
pear, such acts be those of a sane, though morally self- 
perverted mind. 

Many of the cases that appeal to the unwritten law 
come under this latter classification, and demand the most rigid 
inquiry from a psychological standpoint, and consideration 
of all facts, surface or hidden. The study of the woman, 
as well as the man, should be equal, in the inquiry and the 
inquiry should be cold and unbiased, as though eunuchs 
were considering the cause, and it were better if blended 
with a few eunuchs and men past the prime of life there 



210 



Charles H. Hughes, 



were a mixed remnant of middle aged men and women on 
the jury with the young man, where the lex non scripta is 
pleaded. 

The possible sway of erotic emotion were better ex- 
cluded from a trial wherein the chief cause is erotism, and 
their swayed and swaying or attendant passions of jeal- 
ousy, revenge, etc., especially where a tragedy has culmi- 
nated and is involved in the cause of action. Cool blood, 
calm brains, strong deliberate brains should be selected for 
judgment in such cases. Sound psychic conditions should 
exist in all such juries. In fact, the judicial mind should 
be in the jury box as well as on the bench. When shall 
we ever have them in American petit juries? Shall we 
ever have such a jury when one man shoots another about 
an asserted wrong to a young and handsome woman? 

Since "man's first disobedience and the fruit of that 
forbidden tree," the overpowering influence of woman has, 
in certain directions, prevailed with man and no court, ap- 
pellate or others, has prevailed to lessen that influence. 
Her influence is generally acknowledged as in the main a 
good one, but alas! it has been too often an evil one for 
man's highest welfare. And when she influences man in 
wrong directions, man marvels at the unexpected evil in 
her, so "fair, God's eye could look with pleasure upon her 
face, and so pure." "Oh! if she had proclivity to sin, 
Nature may leer behind a gracious mask and God him- 
self may be," — and a giddy blind doubt even of God, over- 
comes man often when a question as to the purity and 
fidelity of the woman he loves, flits like a phantom across 
his trusting mind, such as overwhelmed and astounded 
Walter, in the "Life Drama." 

The "eternal tale" of woman's influence, as well as of 
her prior sin, has been "repeated in the lives of all her 
sons," and it behooves men on juries to be cautious as to 
her story and her power, for there is often an element of 
doubt, sometimes real, sometimes partially hysterically col- 
ored in her testimony, to be taken into consideration by the 
calmly, judicially minded juryman, when the unwritten law 
is appealed to in behalf of the man who has taken her en- 



The Unwritten Law in Our Courts. 



211 



tirely at her word, and without corroborating testimony, kills 
her supposed paramour. 

Juries cannot be selected, except from a panel of the 
average man, with his natural charitable and protective leaning 
toward the tenderly regarded, fragile and physically weaker, 
though often mentally stronger woman, and the legally phrased 
"sanctity of the home." Judge, jury and the average citizen 
justly feel that "he, who would lay hand upon woman, save 
in kindness, is a wretch," and should be treated with due 
vengeance. But what, if after all, the man be really inno- 
cent. The too easily yielding victim of only a woman's 
wiles — a creature helpless and destined for destruction 
through her seductive power, as the strong Sampson was, 
under the powerful, pliant sway of the physically weak, but 
eroto- psychically strong and designing Delilah. 

A blacksmith in East St. Louis sees another man from 
across the street attracting the attention of his wife at 
her toilet in her own bedroom, by those gestures and body 
movements called flirting. Her husband noticing the pro- 
ceeding goes across the street, accosts the man, a stranger 
to him, has a few words with him, strikes him down and 
the man dies. The husband knew not what encourage- 
ment the wife may have given. He makes no prudent inquiry 
before proceeding with the fatal blow, and the 
prosecuting attorney of the place declines to prosecute on 
the ostensible grounds that it would be no use, because 
public sentiment, he said, would let the man go free. He 
is poisoned into disregarding his lawful duty to secure this 
arrogant, ignorant murderer, who made himself ex parte 
judge, jury and executioner, in a cause he holds in con- 
tempt of the law, which his fellowmen, who protect him by 
other laws, have made against the crime of murder. 

This prosecuting attorney, who has ignored the law 
against murder, is yet permitted to hold his position as 
a legal guardian and enforcer of the law. Such men are 
paranoiac in the sense of being beside themselves in their 
right appreciation of duty, of obedience to law and the peo- 
ple who make the laws. Such dereliction should be legally 
punished. 



212 



Charles H. Hughes. 



Two men lately in a Virginia city, for a wrong to their 
sister righted by enforced marriage, together combine after 
the ceremony, to murder the man because they be- 
lieve he is seeking to abandon the girl whom they have 
made him marry. No one has ever learned the man's 
side of the story. Absolute innocence is assumed for the 
woman and flagrant outrage for the man, too outrageous for 
any remedy of law, and the unwritten law is pleaded. The 
judge wisely advises that such a plea is not entertainable 
in a court of justice because not lawful, and that dernier 
resort of otherwise inexcusable criminality, insanity, in most 
peculiar dual form, is pleaded. And a peculiar sort of med- 
ical expert appears to extenuate the crime. 

Let us here introduce some points in the record: 

The trial of James and Philip Strother, at Culpepper, 
Va., March 2, charged with the killing: of their brother-in- 
law, William F. Bywaters, moved rapidly toward its 
conclusion after completion of the expert testimony of 
Dr. Charles Clark, the alienist. 

"Doctor Clark's testimony is regarded as of vital im- 
portance to the defense, although the prosecution claims to 
have enough rebuttal evidence to prove the theory unten- 
able." 

The prosecution will put on several witnesses to rebut 
several statements made on the stand by the Strother 
brothers that Bywaters had no intention of marrying their 
sister, Viola, prior to the time they declare they forced him 
to do so. 

The tedium of the trial was forgotten in the in- 
terest which attached to the appearance of Doctor Clark, 
whose presence was known to mean a bringing out by the 
defense of all the possibilities of its new plea that the 
Strother brothers were seized with uncontrollable emotional 
insanity on the night of the shooting — dual reciprocal emo- 
tional insanity? 

"In my opinion," said Dr. Clark slowly, as Attorney 
Moore, for the defense, ceased reading the hypothetical 
question, "the act was an irresistible impulse, and it can 
also be designated scientifically as impulsive insanity, the 



The Unwritten Law in Our Courts. 



213 



result of a highly emotional state, brought on by many in- 
sults to which the accused had been subjected." 

"I framed my opinion in this case on the hypothetical 
question, and 1 believe it can be logically put into two 
separate acts. The first when they had received informa- 
tion at various times of wrong-doing; on the part of the 
deceased, and the information 'accumulated. As I under- 
stand, they had a consultation, met and considered, and 
waited and reasoned and determined finally to tell this 
young man he must marry their sister or they would kill 
him." This was an exceedingly deliberate, emotional psy- 
chlampsia, not to be found in the domain of clinical 
alienism. 

"Between the execution of the act from the time they 
made their decision there was an interval. During that in- 
terval the mental process was one of peace, as is evi- 
denced by the fact that they congratulated him, and took 
his hand and kissed their sister. And there the mental 
process ended. The new process was due entirely to a 
sudden impulse." (Wonderful psychology ! ) 

"The emotions they had labored under as a result of 
the insults were dormant in them and became aroused 
again. I think the emotional condition overwhelmed the 
intellectual process, and that the act was not committed 
under full volitional power." (Psychic harmony in psychlam- 
psia! ) 

"The witness said he thought that from the time the 
deceased made a sudden break to get out of the room — 
from that time on until the end of the crime — there was 
mental derangement." (In both — a marital murderous 
psychokinesia, so to speak!) 

With the conclusion of Dr. Clark's testimony, the de- 
fense rested its case. 

The State then called Dr. W. F. Drewery, of Peters- 
burg, to rebut Dr. Clark's testimony. Dr. Drewery's 
experience as an alienist had been in treating patients at 
the State Hospital for insane negroes. 

Dr. Drewery was asked whether the effort of the 



214 



Charles H. Hughes. 



Strother brothers to restrain Byvvaters from leaving the 
house had materially affected their mental condition. 

"I should say," said Doctor Drewery, "that they were 
angry— almost to the last degree." 

"Were these men, in your opinion, insane?" asked 
Mr. Keith. 

"No," he replied, "I don't think they were insane." 

Attorney Lee, for the defense, then asked: "Is the or- 
ganism of a Virginia gentleman's mind as sensitive as that 
of any other human being you ever came in contact with?" 

"I think so." 

"You say violent anger, and in almost the last degree. 
What is the last degree?" 
"I don't understand." 

"Can you draw the line of distinction between the 
last degree and that immediately before?" 

"1 don't think that can be done with certainty." 

The succeeding questions were mainly about the differ- 
ent degrees of mental derangement. 

No disease impairing the minds of the brothers is ap- 
parent in the testimony of either expert, such as might 
cripple the mind's power of control and force it out of 
normal harmony with environment, or out of appreciation of 
duty to God and the state and people, or depriving of 
knowledge of right and wrong. There is no impairment of 
their wills by disease-destroying inhibitory power in the 
brain's higher centers shown, that might cause uncontroll- 
able morbid impulse. 

Nothing appears but the ignoring of the normal re- 
straints and the healthy, but unhallowed display of angry, 
vengeful, murderous passion, mocking, at the commandment 
of God and the law of man made in obedience thereto. 
Unbridled vengeance, that, kills a fellowman or woman is 
not emotional insanity. The most violent play of the pas- 
sions in any direction is not insanity, though it may simu- 
late an insane passion, which is disease-impelled and not 
willful, and without motive of vengeance. 

The jury in the Strother case* returned a verdict of 

*The Commonwealth of Virginia vs. James and Philip Strother for the mur- 
der of William F. Bywaters, February term; Culpepper Court, 1907. 



The Unwritten Law in Our Courts. 



215 



not guilty; the judge ordered the crowd to receive the ver- 
dict without demonstration. Notwithstanding, there was 
much handclapping and shouting when the foreman an- 
nounced, 4< not guilty," after but one hour and a half's de- 
liberation. Immediately afterward there was a wild 
scramble over benches and chairs to shake hands with the 
acquitted murderers. Mrs. James Strother fell weeping into 
the lap of her husband, and James also cried. Judge Harrison 
rapped for order, and addressed the jury, several members 
of which were crying. The judge's voice shook and tears 
coursed down his cheeks, saying: "Gentlemen, 1 am glad 
to hear you say that the chastity of our women is to be 
protected; that no punishment shall be meted to those who 
deal with a man who invades the sanctitv of the home. 
1 have no censure for your verdict. Go to your homes, 
and I hope you will find them as you left them." 

Attorneys for the defense were first to shake the de- 
fendant's hands. 

James and Philip Strother, the murderers, said: "It is 
just what we expected. We knew that we had not done 
wrong." Commonwealth's attorney, Wood, apologetically 
said: "We are perfectly satisfied with the finding of the 
jury. We did our best to present the commonwealth's side 
of the case and feel that our whole duty has been done." 

This trial was but a judicially organized mob, acces- 
sory after the fact to the murder and vindicating it. The 
jury, judge, attorneys of both sides, medical experts for the 
prosecution and the crowd vindicating and applauding the 
murderous deed, with no one to speak in behalf of the dead 
man. Who knows what possible secrets the dead man may 
have held, or what motives other than the one proclaimed 
as the woman's honor and the honor of the family, may 
have moved the brothers to murder. 

Here is the remarkable spectacle of two remorseless 
brothers pleading insanity and rational justification of un- 
lawful murder at the same time, the jury acquiescing in the 
double plea, and contradictory, all the attorneys approving and 
the people applauding the verdict in a high court of law, and 



216 



Charles H. Hughes. 



the law of the land saying with holy writ, "thou shalt not 
kill." 

What a spectacle in an American court of justice, her 
scales over-balanced by a burst of erotopathic emotion and 
the rape of the law justified and approved by judge, by 
jury, by medical expert and prosecuting attorney, with apol- 
ogies from the prosecuting attorney. 

Apropos of this subject, we give place to a layman's 
view, as presented by Paul Thieman for Baron Pawel, in 
the Denver Post: 

"The acquittal of the Strother brothers in Virginia, who 
killed their newly made brother-in-law for attempting to 
leave his bride, presents some curious phases of the 'un- 
written law' theory. It is true there was a pretense in the 
trial of showing emotional insanity, but, as the judge 
thanked the jury and extolled their verdict, it is hardly pre- 
tended that it is anything but justification of the exercise 
of family or private revenge * * * The facts estab- 
lished beyond dispute in the evidence were that the slain 
man had wronged the sister of the defendants; that he 
had been induced, probably under compulsion, to repair the 
wrong by marriage, and that he attempted, at once, to 
leave on the plea of business in town, whereupon the en- 
raged brothers shot him. The most unfavorable con- 
struction of his attempt to go away after the wedding is 
that he intended to desert his bride. Therefore the 'un- 
written law' works out, in this case, to be that wife deser- 
tion is an offense for which the relatives of the deserted 
wife had the privilege of inflicting capital punishment, and, 
moreover, to act as prosecutor, judge, jury and execu- 
tioners, all in the length of time that it takes to draw a 
revolver and get it in full action. * * * Another notice- 
able feature is that the judge who thanked and indorsed 
the jury for this verdict had in the earlier stages of the 
same trial emphasized, most emphatically, that no unwritten 
law would be recognized in his court; that he and the jury 
were sworn to enforce the statute law, and that would be 
the only test in the case. As it would be impossible to 
produce any statute enacting the theory of private capital 



The Unwritten Law in Our Courts. 



217 



punishment for wife desertion, it does not seem that this 
judge's law is like that 'of the Medes and Persians, which 
altereth not'." * * * Well said Baron. * * * it is 
an illustration of the vagaries of any law that is not a 
statute law. * * * While the "unwritten law" is quite 
specific, the fact that it is not written enables its code to 
be distorted and misused and, out of sympathy for the ac- 
cused, its protecting sentiment may nevertheless be in- 
voked, * * * The Strother brothers broke the "unwrit- 
ten law" itself, for, according to the "code,'" they had ac- 
cepted marriage as reparation and Bywaters was entitled to 
a decent chance to act like a man. * * * But a dis- 
pute arose, hard words were passed and, in mere rage, he 
was killed. * * * Public sympathy, however, gave to 
the Strothers the immunity of the "unwritten law." 

Solomon, with all his wisdom and familiarity with 
women, confessed his inability to understand the way of a 
man with a maid. The way of a maid with a man is 
often quite as incomprehensible, and the way of petit juries 
with this unwritten law plea and a women in the case is 
peculiar. 

There appear to be times and seasons and places with 
the American people when and where deliberate reason for- 
sakes them in the face of certain crimes against the law, when 
an insanoid sort of judgment supplants the cold reason of 
judge and jury, and this unwritten law craze is one of 
them. 

These crimes of insanoid emotion displayed in such 
jury verdicts against the law of the commonwealth, which 
assumes to "command what is right and prohibit what is 
wrong," and in the present instance approved by the court, ap- 
pears strange and unaccountable to the psychologist, as coming 
from supposedly sane and well-balanced minds, with the 
law to guide them and the command of God to deter them. 

If this craze to kill in these cases, on the assumption 
that "woman can do no wrong," goes on increasing, better 
extend the application of the lex talionis to gradually in- 
clude them, than make a farce of law and a travesty of 



218 



Charles H. Hughes. 



cool-headed justice with subterfuges of non-existent 
emotional insanity, as a plea in vindication. 

There are base, insidious, slimy lechers in this land, 
as in every other, who creep into the chambers of a 
woman's soul, "like a foul toad, polluting" as they go, for 
whom shooting is reward rather than punishment. But how 
are such to be separated from the weak, unwary man se- 
duced, if the seducer is dead and only the woman's testi- 
mony is taken, with none to dispute, and what becomes 
of the right of the murdered one to have had a hearing 
and to confront witnesses and charges against him. 

The man who with overmastering violence or stealthy 
drug giving, with wine or otherwise harmless beverage vio- 
lates an unwilling woman, should meet with condign pun- 
ishment by law, under fair legal inquiry and decision but 
never by private vengeance. 

It is lame psychology and bad logic that assumes al- 
ways the sanctity of the home, forcefully, ruthlessly invaded 
by resistless lechers, before whom virtue must inevitably 
succumb like a voyager, to "pirate monarch of the main." 

The sanctity of the home is, save in exceptional in- 
stances, maintained by the true and, many of them saintly 
women, within the home. The sin of erotic unsanctity, 
or speaking in terms of less specious sophism, the sin 
of erotic conjugal infidelity is prima facie, a mutual sin in 
the fully mature not where one is under puberty or lawful 
age of consent and sexually innocent and no one better 
knows this fact than the cold, reasoning psychologist and 
physician familiar with all the phases of the erotic sexual 
life of man and woman and, as that life is familiar to the 
student of morbid erotopsychology, such as the alienist, under 
whose eye so often comes the extremes of sexual eroto- 
pathy in man and woman from erotic hypaesthesia and 
hyperkinesia to sexual apathy senile and premature. 

The "ruin of innocence and virtue," "the polluting of 
the home" are facts that arouse right manhood's vengeful 
ire and the threatened or violated "sanctity of the home" 
from erotic, lustful, polluting invasion from without, stirs the 
innermost feelings of destroying vengeance leading to trag- 



The Unwritten Law in Our Courts. 



219 



edy. But before juries these phrases are often misapplied. 

Used as specious catchwords of forensic suasion, not 
supported by justifying evidence, where the unwritten law 
is appealed to, and one of the principal and most essential 
witnesses is dead, and his or her character and possible 
crime are being passed upon ex parte. 

Here, more than anywhere else, in view of the dominance 
of the sexual over the other passions and over the mental 
stability and inhibitory powers of the brain, too often is the 
medico-legal difficulty of providing for right law and evi- 
dence. One thing is certain, the law should not be in the 
hip pocket or under the plaquette of the emotionally dis- 
ordered party, who believes he or she has been wronged 
beyond remedy, save that of self-decided and executed 
bloody vengeance. 

The line of demarkation between sanity and insanity 
is often so shadowy that even largely experienced ex- 
perts in alienism can not always promptly detect it. But 
when, in a case where the unwritten law for a crime con- 
nected with erotism is appealed to in justification of sum- 
mary murder, jointly planned, a jury immediately acquits, 
the presiding judge commends, the prosecuting attorney 
apologizes, the whole audience applauds and the murder- 
ers are acquitted on the woman's and their own testi- 
mony, thank the jury with expressions of confidence in the 
righteousness of their act, a state of unseemly emotional 
and semi-hysteric excitement pervades the audience, not 
compatable with a normal, steady, unmoved judgment, and 
Justice is wronged in the sacred temple. Vengeance be- 
yond the law commended, murder rejoiced in; such a place, 
such circumstances, such scenes of inordinate emotional 
sympathy do not promise that equal and exact justice, which 
should always and only appear in our courts of justice from 
cool, calm, unbiased deliberation upon a matter of such 
character to man or woman, and when a like and equal 
justice to all are at stake. 

An American jury box, American bench or bar or seat 
for auditors, are not the places for insanoid emotional dis- 
plays that lack only the unestablished element of disease 



220 



Charles H. Hughes. 



of the psychic neurones to constitute the mental instability 
of insanity. 

From the standpoint of a neuropsychologist's observa- 
tion in provision for neurone stability, and in right penal- 
ties perhaps, for causes and trials of this kind, this subject 
would appear to require further attention from municipal 
law-making powers. 

The anthropology of man and woman are similar, com- 
plementary and anthropopathically reciprocal, as their an- 
thropology is much alike, both neuroanatomically and neuro- 
physiologically in their eroto- sexual spheres, with the super 
addition to woman of her especially receptive generative 
apparatus and the ovi complementing the testes. 
"As unto the bow the cord is, so unto man is woman" in 
neuroanatomical and neurophysiological life and laws for 
trials in which she is directly or indirectly concerned, es- 
pecially where capital crime is the issue, should be made 
accordingly. 

Her testimony and its motives should be weighed with 
extreme knowledge and caution, from the standpoint of a 
correct knowledge of erotopsychology. 

The anthroposophy of this subject, demands a full and real, 
not an erotic delusional knowledge of woman's nature, so like 
unto man in passion, yet variant in display and more se- 
cretive. 

This knowledge is what we ask in these trials, embracing 
the anthroposcopy of her artful, artistic and seductive powers 
of speech and manner to sway man's overpartial judgment on 
the witness stand, in these erotic murder cases or through 
what we know of her merit and beauty of character in our 
own homes, and of her real nature in general, as she really 
is, so different from, yet so like unto man himself, in her 
passions, some supremely good, some supremely bad, some 
indifferent, as men are. This should be considered in 
every cause wherein the unwritten law is concerned. Not 
that the woman should be regarded as only good and pure 
and true, and only man as base and vile. Juries should re- 
gard them and their testimony in the light of true, un- 
jUusioned, psychological anthropology. 



The Unwritten Law in Our Courts. 



221 



When there is, or has been a woman prominent in the 
cause, it is well for the man to severely and strenuously train 
his logical inhibitions on his judgment, lest he be unduly swayed 
by overbiased, erotopsychic emotion and mistake the same for 
sound, impartial judgment. 

Recently a man repeats the often recurring domestic trag- 
tragedy of killing himself, his wife and child under the eroto- 
pathic, psychlampsic impulse of homicidal jealousy. No law 
but the law of extermination for him, the destruction of the 
unfit to live and he unconsciously thereby saves the good 
of his race in thus summarily destroying himself as a 
breeding focus of psychic morbidity, inimical to the eroto- 
mental stability of generation that might have directly or 
atavically come out of the mentally unstable and mismated 
combination, for like breeds like, in neuropathy and psycho- 
pathy, as in generations of a sounder, steadier- neuroned 
cerebro - psychogenesis. 

The constant in and in breeding of the psychically unfit to 
live for the welfare of the race, is a source of solicitude to 
the patriotic psychologist and alienist, and thought of remedy 
of prevention has often presented itself, but how to apply 
it has been as much of a problem as the. belling of the cat 
to a council of rats. Nature's remedy in the often 
suicidal violences of morbid jealousy, is a harsh one, 
but effective, and the race is benefited in the survival of 
the more stable and normal in erotic neurone life, and 
consequently more fit to live. This remedy of inexorable 
nature, remedying its erotic life defects by pyschophysical de- 
generation or suicide is revolting to our tender sense of re- 
gard for the life of others. But it is Nature's unfeeling, 
effective way, the way that prevents idiocy and misce- 
genation or other defectives going too far in continuation 
of their vicious kind to the peril of the general brain stabil- 
ity of mankind. The unfit to live thus fall by the way and 
perish through erotopathically begun and continued degen- 
erative impotential decadence. 

Here are some other aspects from England of the unwrit- 
ten law, so-called, which we give without entirely endorsing 
the criticism of the paper from which we abstract it. 



222 



Charles H. Hughes. 



"Public indignation has followed the sentence of death 
upon the young man, Rayner, for the murder of William 
Whiteley, known as the "universal provider." Before the 
trial and while it lasted English law very properly prevented 
an expression of public opinion. 

"To print any opinion which might have its effect 
upon the minds of the jury while a case is subjudice is 
held to be contempt of court, rendering the offender liable 
to a severe term of imprisonment, but now that the trial 
is over the newspapers are full of angry letters denoun- 
cing the sentence of death, especially as the judge said the 
prisoner need not expect any reprieve. 

"Raynor claimed that he was an illegitimate son of 
Whiteley, and had his mother's evidence in support of the 
allegation. In fact, he called himself Cecil Whiteley, 
when he was charged with the murder. 

"He was married, and, with his delicate wife and two 
children, he came to London, starving, and went to White- 
ley for assistance, hoping that his father would help him 
obtain employment. 

"He had a revolver with him, with which, he said, he 
meant to blow out his own brains in the event of his 
father's not doing anything for him. He did not want 
money, but work. 

"Whiteley declined to help him, and, so Rayner says, told 
him to go to the Salvation army for assistance. In his 
weak, nervous, and starving- state that made his blood boil, 
and he was raised to greater passion when Whiteley sent 
for a policeman to have him removed. He then fired at 
Whiteley and followed that up with shooting himself 
through the head, blowing out one of his eyes. Whiteley 
died, but Rayner was nursed back to life. 

"Was Rayner justified in taking the life of this man, 
whom he called father? The controversy, through the 
medium of the country's press, is heated, but a great ma- 
jority of opinion is on the side of the condemned man. The 
country is horrified that a young man should have to 
undergo torture under the surgeon's knife and be nursed 
bat k to life only to be given up to the hangman, 



The Unwritten Law in Our Courts. 



223 



"Laurence Irving, son of the late Sir Henry Irving, thus 
voices the general feeling throughout the country when he 
asks 'if Rayner, under the stress of hunger and its attend- 
ant miseries, having pawned everything down to a woolen 
muffler, believing that the man to whom at last he ap- 
pealed for help was his father, or, in any case, knowing 
that he had been connected with his mother's family to its 
dishonor, and that, being refused assistance, he shoots Wil- 
liam Whiteley and then himself, can anyone question that 
in the moments when he lay moaning on the floor asking 
only to be allowed to die, and in the succeeding days and 
weeks, when that sad, wrecked, loathsome thing, his life, 
was being given back to him, can any one question that in 
that interval he suffered all and far more than all pangs of 
hanging.' 

" 'An idea at which public conscience revolts is that of 
Rayner undergoing a more awful measure of punishment 
than Chapman or Deming, who tortured their victim to 
death, or that hideous Jack the Ripper would have done 
had he been caught. To the plain nonlegal mind this is 
not justice.' 

"Thousands of letters written in the same strain say 
if Rayner is hanged it certainly will afford a strange ex- 
emplification of the peculiar workings of English criminal 
law. Only a month or two ago a young man in Brixton, 
one of London's suburbs, stabbed to death a girl who did 
not reciprocate his affection as he wished ; yet his story 
was considered so pathetic that the death sentence was 
commuted on the ground that he was insane at the time 
he committed the act, and in six months' time he will be a 
free man again." — N. Y. Herald. 

A candid consideration of the above and the views of 
other popular writers and persons on these and similar 
features of the unwritten law sentiment, suggest that 
there is something even in the normal psychology of the 
subject, which has not yet been adequately met by such 
legal provision as would take proper punitive law, lex 
talionis and lex non scripia out of personal hands and place 
them in the courts of justice. 

(To be continued.) 



THAW'S PARANOIAC MORBID EGOISM. 



By C. H. HUGHES, M. D. 

St. Louis. 

A PRESS REPORTER sitting in the court room of this 
famous trial has builded better than he knew, one of the 
foundations of Thaw's abnormal mental state. It is that 
morbid state of mind which, in Thaw's speech and conduct 
shows intense abnormal egotism, the exaggerated egotism 
as testified to by medical experts Evans, Wagner and others, 
founded in the delusion that he has done a justifiable, righteous 
detd of retributive vengeance approved of God and applauded 
of men and women, in slaying the demon who has menaced his 
mind and his life. "When the world shall know in full the 
motive of the deed and the character of his victim, the de- 
spicably damned, stealty destroyer of the virtue of trustful 
maidenly innocence, it and God will, in his morbidly eroto- 
pathic delusion, justify and applaud the taking of White's 
life and the violation of the law, and set him free with 
honor and gratitude." Here is the potent press portrayal, 
unconscious of its alienistic significance, of that picture which 
marks mental disease upon the thought and action of this 
man. 

"Something of the pomp of a general suggests itself in 
the demeanor of Harry K. Thaw in his trial for the murder 
of Stanford White. He seems ambitious to push the cam- 
paign. There is no listlessness, no timidity. He is impa- 
tient for the crux of the trial, else his manner belies him. 
He can hardly wait for the climax. He is the same Harry 



(224) 



Thaw's Paranoiac Morbid Egoism. 



225 



Thaw he was on the night of the Madison Square garden 
tragedy, when he strode into the police station with his 
head up, his shoulders back. He slapped his breast with 
his hand, "I am the man who did it, — no, proclaimed it!" 

"Modified, of course, his attitude is the same. He 
marches into the court room with the alacrity of one who 
is used to the center of the stage as his right. The eyes 
bent upon him from the thronged court room are so many 
spotlights. He sees them all. He looks around to see 
if they are there. 

"Over to one side are tables creaking under the fever- 
ish writing- of a host of reporters, correspondents. This is 
the press. Ah, the press is another spotlight. 

"The man who "did it" is here. He has waited since 
last June to tell it. He thinks he is going to tell it in a 
few days, and is more eager than ever. Maybe, his law- 
yers will say differently, but he does not dream of that. 
He feels that he is there to re-enact the tragedy. 

"Behind Thaw, the ambitious general, sits his first 
reserve. 

"There are five women sitting: behind there, three in 
somber garb, the other two flashing with purple in their 
attire. 

"Of the latter, the small, insignificant one, with a pair 
of startled eyes peering out through a thick, smothering 
veil? What of her! For her he slew. 

"is Harry Thaw's sense of importance felt toward the 
public, or is it all to impress the mite of humanity? (The 
trial shows both.) 

"There are the other women. That white-haired one 
is his mother. She has a clear eye and a good color. She 
has courage. 

"He never had to pose to her as a hero. She always 
thought he was one, where even his most indulgent friends 
realized the bitter truth. She is the most loyal one of all, 
the most hopeful, perhaps. She is his mother. 

"There is another woman, a countess, made so by 
marriage. 



226 



Charles H, Hughes. 



"There is another, a sister, one more commonplace. 

"Now the other woman. The other one wears colors. 
She comes from the chorus girl ranks where the wife grad- 
uated." 

These five women make up the feminine part 
of the auditors in whom he is most interested and whom 
most of all he wishes to behold his triumphant vindication. 
But there are others, the great audience of onlooking 
women for whose virtue he has valiantly stood, and men 
who have wives and daughters, and the jury who will 
weigh the scales of justice, and read the weight of evi- 
dence of his valor, and the judge and attorneys, who will 
help in the weighing, and the witnesses who are to tip the 
scales so pronouncedly in favor of his great and meritori- 
ous achievement of avenging blood." No show or line of 
remorseful regret mantles the face of this egoistic paranoiac, 
as he looks with exhuberantly conscious assurance, 
though that assurance be that of morbid delusion not yet 
justified by the revealed facts, upon the great audience 
of the crowded court room, ready and eager in his morbid 
imagination to proclaim the glory of his great act of 
retribution. "His act and God's." 

The world is full of egotists who, without just warrant 
in personal ability or merit, esteem themselves far above 
all reasonable warrant. The reckless plungers in finance, 
the despicable, obnoxious, smart-Alex's and egotists of 
society who obtrude, out of their proper place, in so many 
spheres of action where sensible men only should be, are 
of this class, but here is the egotism of a morbid egoism, 
which makes a remorseless delusive merit of shedding human 
blood, for a delusional personal danger and an old wrong, 
real or apochryphal, told of, and if real, condoned in con- 
jugal alliance and passionate love of the woman wronged 
after two years of illicit amour. 

This mentally deranged man of morbid egoism and fea r 
of enemies and persecution, distrustful of his own counsel, 
autocratically dismissing and changing them because they 
wished to establish exculpatory insanity, is fearful that 



Thaw's Paranoiac Morbid Egoism. 



227 



he will be pronounced insane when he knows he is not 
mentally deranged. 

He doubts the sanity of the medical experts who 
observe him and are testifying to his insanity. "They do 
not understand him." These opinion witnesses had, in the 
beginning, great difficulty in getting audience with him. 
Later he courts the examination of the lunacy commission 
because "he knows he is perfectly sane." When the experts 
first visited him he regarded them with suspicion, though 
introduced by a friend in whom he had yet faith (Mr. 
Hartridge) and left them abruptly without asking to be 
excused, though he has been gentlemanly reared and accus- 
tomed to the manners of a gentleman. 

He looks with delusional confidence and pride upon the 
judge, the jury, the audience and his family and upon the 
insanity commission. "He has done a righteous deed." He 
is confident, hopeful and anticipating triumphant vindication. 
"The murder was of providence, an inspiration and his wife 
an angel, not fallen but cast down by treachery and violence. 
He is the greatest and the best of heroes, an avenging nemesis 
who before all the people, killed the infamous one and with 
weapon in hand and uplifted arm had let all see and know he 
did it. Openly done as Booth's shooting of the good Lin- 
coln, boldly proclaimed and with no attempt at escape. He 
now sits satisfied before the tribunal of the people, hopefully 
awaiting their plaudits of well done, after the jury shall 
have set him free for his glorious deed of providentially 
directed vengence. He industriously and interestedly exam- 
ines and attends to his correspondence, paying no attention, 
most of the time, to what the medical experts are saying 
about him, because in his self-laudatory delusion the end 
will be a sure vindication. It is all right anyway; in his 
mind, all will be, must be right. He will be acquitted with 
applause for the righteous murder of the man who, before 
he knew her carnally or had conjugal claim upon her, had 
also carnal unlawful commerce with his wife as he had 
later himself, and for two years before his marriage to her." 
He faces the commission of inquiry into his sanity or insanity 



228 



Charles H. Hughes. 



of mind with confidence of a verdict of sanity and he is 
right in his egotistical conviction, "for the inquiring commis- 
sion are men, like himself, though one is a physician, and 
would have acted the same, had they the same knowledge, 
the same courage, the same wrong to avenge, the 
same conviction, the same support of Heaven." In ad- 
vance of their decision he complacently receives the righteous 
verdict as he regards it, of his sanity and the jury's 
just verdict of acquittal, for in his own mind he has done 
a glorious, heroic deed. But lo! the jury has in his delu- 
sioned view, made a grave mistake. "It has failed to see 
the glamour and the glory of his great and meritorious deed 
of death and salvation. But the commission of inquiry has 
concluded aright. He is sane! The jury did not see aright. 
They were divided, some of them even thought him guilty, 
though he had removed from the earth a malefactor who 
to his certain knowledge had dishonored his wife in her 
girlhood before he himself took her as his concubine and 
traveled with her for two years under an alias." In his 
exaggerated morbid egoism what he did was alright. All 
and every one who came across the mental orbit of his 
morbid egoism were all wrong and he has a way of righting 
every evil and will use it. "He will go to jail to be bailed 
out soon, he thinks, and a new trial with new attorneys 
and new judge with broader views and a more appreciative, 
sensible and sympathetic jury will see him and his cause 
aright and indicate both in a just verdict of freedom cum 
lauded 

To these insane convictions we add another reporter's 
view in contrast to that the delusioned Thaw had of his deed 
of blood and this reporter's view is the view Thaw would have 
held of himself had he been sane. But had he been sane, 
though the same deed of blood might have been done by 
him, he would have done it at anotHer time and place and if 
possible, with reasonable effort at concealment and escape. 
Thaw's delusion of his wrong and his insane state of 
brain, did the deed in the manner and place in which 
it was done. It was done when, where and in the manner 
it was, because in his morbidly delusioned state of mind it 



Thaw's Paranoiac Morbid Egoism. 



229 



was the time and place and he the heaven chosen actor of 
a great and glorious deed. 

"Jealousy of his beautiful wife, whose lustrous eyes 
and artist model figure thrilled even the pampered profli- 
gates of the Rialto, led Harry Kendall Thaw, the spoiled 
scion of a wealthy and indulgent family, to kill Stanford 
White at Madison Square Garden on the night of June 25, 
1906. The young millionaire believed White was seeking 
to separate him from his wife and emotional (?) insanity is 
the plea on which his attorneys hope to save him from the 
electric chair. 

"No mystery veils this remarkable case. Thaw killed 
his man where all might see, and held the smoking revolver 
in his hand until a policeman took him by the arm. The 
openness of the deed incited the greatest speculation as to 
the nature of the defense. Not once in the long seven 
months which passed after the prison doors had closed 
behind Harry Thaw has the slightest intimation been given 
as to the plea that would be offered. One million dollars 
may be spent to save Thaw from the death penalty — 
half the sum already has been spent. (?) An assistant 
district attorney remarked at the time of the killing: 

"This man thinks he can get out of this scrape as he 
would avoid trouble after he broke a barroom mirror — by 
paying for it." 

If Thaw goes free, he will re-enact perhaps another 
tragedy of horror, if similar adequate or fancied provocation 
shall again disturb his paranoically unstable brain and 
provoke another deadly mental explosion. Such may be 
confidently looked for, if his future like the past, be an 
unbridled career of self-indulgence without asylum control 
and treatment to restrain his hitherto unregulated and abnor- 
mal inhibitions. It will be a misfortune for him and his family 
or friends who may come intimately near this paranoid 
psychopath if he should not be subjected to a long period 
of mind steadying restraint, free from all the vicious indul- 
gences and non-regulation to which he has become accus- 
tomed by an erratic paranoid life, that brooked no restraint 
and knew no guidance but the impulses, propensities and 
dominating passions of his own "sweet" and erring will. 



THE 

ALIENIST AND NEUROLOGIST- 



VOL. XXVIII. ST. LOUIS, MAY, 1907. NO. 2. 



Subscription $5.00 per Annum In Advance. $1.25 Single Copy. 



CHAS. H. HUGHES. M. D.. Editor. HENRY L. HUGHES. Manager and Publisher. 

Editorial Rooms, 3872 Washington Boul. Business Office, 3872 Washington Boul. 



This Journal is published between the first and fifteenth of February, May, August and 
November, and subscribers falling to receive the Journal by the 20th 
of the month of issue will please notify us promptly. 
Entered at the Postoffice In St. Louis as second-class mall matter. 



EDITORIAL. 

[All Unugmd Editorials art written by the Editor.) 



THE UNQUALIFIED EXAGGERATED EGO as a defense 
of erotic brain-storm murder was brought into requisition 
at a recent murder and unwritten law defense trial at 
Carthage, Mo., in the case of the State vs. Sanderson. 

In this case the prosecuting attorney said there was 
evidence of an exaggerated ego, in that the defendant 
thought himself providentially called upon to avenge the 
ravishment of his wife. 

Sanderson shot Doctor Meredith at the Sanderson home 
early in the morning of January 2, after having telephoned 
for the physician to come to his home to prescribe for Mrs. 
Sanderson. 

In his defense Sanderson claimed that Meredith was 
advancing upon him with an upraised medicine case and 
his right hand to his hip pocket when he shot him. Mrs. 
Sanderson told the jury and the jury accepted the improb- 

(230 



Editorial. 



231 



able, if not impossible statement, unless Dr. Meredith was 
ambidextrous, of Meredith's alleged advances to her and 
corroborated the statement of her husband, the defendant, 
in regard to the shooting. 

She testified that Doctor Meredith, who had been their 
family physician, had made love to her when she went to 
his office to consult him. 

Later, when one of the Sanderson children was ill and 
Sanderson wanted to send for Meredith, Mrs. Sanderson had 
demurred and said that some other physician should be 
called. Sanderson insisted upon knowing why she objected 
to Meredith, and Mrs. Sanderson detailed her experiences 
with him. 

Sanderson immediately left the house and soon returned 
with Doctor Meredith. Before Mrs. Sanderson, he accused 
the physician of ruining his home and shot and killed him. 

In his dying statement Dr. Meredith denied criminal 
relations with Mrs. Sanderson, which was probably the 
truth. The woman had probably made a derogatory state- 
ment about Dr. Meredith, for a woman's reason, which after 
the disastrous result and to save her husband, she exagger- 
ated probably into coerced adultery which, though unsup- 
ported, the jury accepted as absolute truth and justification. 

While protecting the purity of the home it would be 
well if juries would consider the possible purity and honor 
of medical men in spite of erotopathically framed stories of 
morbid hysterical women, eager to make impressions on 
their husbands of other men's attentions. There is a kind 
of morbidly-minded, overly erotic woman who sees the 
masher and the flirt in every genteel man they meet who 
innocently looks upon her. Such women are ready, for 
motives peculiar to this peculiar class of the sex, to say 
to their husbands and lovers for jealousy exciting effects, 
that such and such men lust after them. Such giddy fem- 
inines, to whom love is their whole existence, do not realize 
what they do sometimes with the passion of certain impres- 
sible men who sustain the closest of human relations 
to them, when they disclose hysterically colored, illusory 



232 



Editorial. 



romances of erotic adventures from forbidden sources, till 
the unexpected awful tragedy happens. Then, in some 
instances at least, they tell of their shame, which may 
never have happened, to save the life of the rash, impetuous 
loved one, who under the unwritten law then regards no other 
life as sacred that really, or in feminine fabrication, passes 
between him and the woman. 

Making a clean breast of infidelity and ruin, as if women 
were babes and men were beasts, going back to the wronged, 
forgiving husband and saving his life by the terrible sacrifice 
of really or falsely testifying to her own shame and weakness 
and the man's great over- powering- wrong, and swaying 
a jury into forgetting the law and their obligations to 
society and logical truth in their deliberations, is becoming 
a problem in psychological anomaly closely verging upon 
the morbid. 

Brain-storms are "sudden and severe paroxysms of 
cerebral disturbance." Psychokinesia and psychlampsia are 
the technical terms of this state of mind connected with 
insanity. Explosions of violence, in the height of passion, 
may be sane displays of temper, but when morbid, with a 
well-laid foundation of disease affecting the brain, they are 
evidences of insanity. To constitute insanity, psychlampsias, 
psychokinesias, brain-storms, or plain explosions, of blind 
passion must have a brain affecting disease basis. Other- 
- wise they are just plain giving way to violent reason- 
blinding, punishable passion. 

THE JOURNAL OF INEBRIETY, is now united with The 
Archives of Physiological Therapy. It will hereafter be pub- 
lished as a part of The Journal of Inebriety. These two very 
able periodicals will move on as two souls with but a single 
thought and two hearts that beat as one, in editorial man- 
agement. The management thinks the scientific value of 
both will be greatly enhanced by this concentration. 

The merit of the high contracting parties make the 
marriage appear auspicious and our auguring mind, knowing 
both sources, assures success for the joint adventure. 



Editorial. 



233 



PYROPHILES AND PYROPHOBES are not uncommon 
among: the insane, who love to see and make fire or dread 
and fear fire from pure love or aversion of a diseased brain, 
without special delusion on these subjects. The diseased 
impulse with them to burn or see fire or to dread fire is a 
simple delusive feeling. 

PARANOIAC, PYROMANIAC AND HOMICIDE are rarely 
combined in one person. Such a case is lately recorded by 
the Associated Press as occurring at New Martins, Virginia, 
where on January 30th, claiming that God had instructed 
him to burn the town of Smithfield, Harry Howard was 
arrested there recently as he was emerging" from a 
hotel, which, it was said, he had attempted to fire along 
with three other buildings, from which flames were bursting. 
The fires, however, were extinguished. Howard resisted 
arrest, and before he was captured, shot and probably 
fatally wounded one man and injured others, including the 
Chief of Police. 

THE ST. LOUIS ALAMAGORDO TUBERCULOSIS SAN- 
ATORIUM, located in New Mexico, represents a practical 
philanthropy worthy of ample support by St. Louis philan- 
thropists and emulation by other cities. The atmosphere 
of New Mexico admits of curative open air treatment most 
of the year and the promoters of this merciful movement 
are. wisely constructing a forty-room building in addition 
to the tents provided ip order that the patients may get 
the right sort of fresh air at all seasons. The exclusive tent 
idea for every day in the year is a fatal fad and has caused 
many early deaths of consumptives forced to live in unfloored, 
unheatable and too lightly walled tents in inclement weathe r 
such as would make a well man ill. 

The rates for medical attention and maintenance will 
be as low as seven dollars per week. 

Detached from building, canvas tents and a main admin- 
istrative building are in the plan. 

A Sanatorium Magazine is contemplated, to explain the 



234 



Editotial. 



work and disseminate special information concerning this 
praiseworthy institution. 

The present directors and promoters include Mayor 
Wells of St. Louis, Paul Brown, E. Wilkerson, Geo. 
Frankel, C. F. Hatfield, M. P. Moody and others. 

If this scheme is carried on from the start on perfectly 
antiseptic lines, so that it will not become a nucleus for 
the dissemination of tuberculosis, as Mentone and other 
places have, and as a pure philanthropy it can be made 
more than sustaining and do a world of good to moderately 
circumstanced people, who have upon them the great incubus, 
mental and pecuniary of one or more tuberculotics in their 
families. The depressing influence of a tuberculotic to 
himself and to" those bound to him by ties of consanguinity 
and natural associate sympathy, can thus be removed and 
that psychic buoyancy so essential to the promotion of 
recovery in any disease can be brought to bear by removal 
from home to the better sanitary environment of a New 
Mexico mostly out- door home. 

The meats and milk, as well as the atmosphere of New 
Mexico, are less likely to be tuberculotic than those of large 
Eastern cities. The Government's Inspector last January, 
at Trenton, New Jersey, found twenty-five out of fifty 
hogs tuberculotics and they probably were not fed on 
garbage as infected as that of our St. Louis Chesley Island 
either. 

Devising distant sanatoria for tuberculotics and feeding 
people infected food and drink and on the foul germ filled 
air of city street cars, etc. is essaying sanitation at but one 
end and that not the most effective. 

The best time to quench the fire of disease is to not 
let it get a start. Chesley Island hog feeding is an unsan- 
itary and murderous blunder and crime. To whose tables 
do the hogs go or to what use are they put that are fed 
on Chesley Island garbage? 

A STRANGE PROCEEDING in the Thaw trial required 
the experts to establish insanity before testimony would 
be admitted on the subject. 



Editorial. 



235 



Experts should have all the facts, whether obtainable 
from lay or professional source, whether from personal obser- 
vation or the testimony of others. The claim of insanity 
should have the chance of proof from all the testimony. 
The hypothetic case should be a complete life biography. 

IT IS UNFAIR TO THE INSANE to have lawyers or 
laymen on a commission of inquiry as to a strictly medical 
question. Such a commission should be composed only of 
clinically experienced alienists to do justice to a supposed 
insane person. Insanity is a disease of brain disordering 
the mind and should be diagnosticated, as other diseases 
are, by doctors of medicine, not by lawyers and laymen. 
No one would think of diagnosticating any other disease 
after the manner of the New York commission in lunacy. 

IT IS UNFAIR TO AN INSANE PERSON to pronounce 
him sane because he may appear to be able to advise with 
his counsel as to the conduct of his case. This is the 
unfair criterion in Thaw's case. 

IN INSANITY, APPEARANCES ARE DECEPTIVE to the 
non-expert. The "knowledge of right and wrong test of 
insanity" is a wrong and unjust criterion for insanity. 
Insane persons may appear to have that knowledge and 
acknowledge that they have, as they will insist that they 
are sane, while yet they do not have the knowledge of 
right or wrong as a sane man does. 

THERE MAY BE GRAVE BUT MASKED DELUSION 
behind an insane man's abstract knowledge of right and 
wrong. In insane psychlampsia insane persons have been 
resistlessly impelled to murderous deeds they knew were 
wrong and against their normal inclination even while 
imploring to be restrained and prevented. 

"The existence of this form of insanity is now too 
well established to be questioned by those who have any 
scientific reputation to lose." — /. Ray, Med. Juris. Insan. 



236 



Editorial. 



APROPOS OF H. K. THAW "It must not be forgotten 
that the author of our being has endowed us with 
certain moral faculties comprising the various sentiments, 
propensities and affections, which, like the intellect being 
connected with the brain, are necessarily affected by path- 
ological actions in that organism. The abnormal condition 
thus produced may exert an astounding influence on the 
conduct, changing the peaceful and retiring individual into 
a demon of fury or at least turning him from the calm and 
quiet of his lawful and innocent occupations, into a career 
of shameless dissipation and debauchery, while the intel- 
lectual perceptions seem to have lost none of their ordinary 
soundness and vigor." — /. Ray. 

DEATH OF R. HARVEY REED OF WYOMING.— Dr. 

Harvey Reed of Rock Springs, a former member of the 
Wyoming state legislature and a prominent Republican 
politician of Sweetwater county, committed suicide in a 
hotel at Los Angeles, Cal., by sending a bullet into his 
right temple. 

The suicide is attributed to ill -health and despondency. 

Reed had been living at the hotel for several weeks, 
and during this time he had been confined to his room in 
charge of a nurse, who accompanied him from Wyoming. 
It is said that while the nurse left the patient for a few 
moments to-day, Reed procured a revolver in the room and 
ended his life. 

For several years Dr. Reed was surgeon for the Union 
Pacific Coal Company. He was superintendent of the 
Wyoming general hospital at Rock Springs for several years 
and was surgeon general on the staffs of Governors W. A. 
Richards, Deforest Richards and Fenimore Chatterton. 

Dr. Reed was a self-made man of great force of char- 
acter. A good surgeon and a good friend. We send his 
family and associates the condolences of a friend. He was 
our traveling companion along with Drs. Senn and Grif- 
fiths from this section of the country to the last Inter- 
national Congress of Medicine at Madrid. 



Editorial. 



237 



A RATIONAL AND VILLAINOUS BRAIN STORM. — 
A St. Louis restaurant employee expecting fifteen cents 
more pay than was paid him for a day's work went 
into the restaurant with his knife open because he 
"expected trouble" as he confesses and "was mad" and 
fatally slashed the proprietor in the back and side. This 
is another phase of the unwritten law that should be written 
plainly in the severest legal punishment. There is a wide 
field for legal punitive education here as in other forms of 
the personal practice of lex taliones. 

Because he believed he was being cheated out of 15 
cents, Roy Spurgeon, of No. 2647 Olive street stabbed 
William Amenda, manager of the restaurant at the Portland 
Hotel, No. 1817 Market street, five times. 

The restaurant was crowded with people at the time. 
One patron sprang to the door and locked it as Spurgeon 
was trying to escape. Another, whose identity was not 
learned, struck Spurgeon on the head with a chair, ren- 
dering him unconscious and gashing his scalp. 

Blood flowed freely over the floor of the restaurant and 
excitement prevailed for a few moments. Sergeant Fields, 
of the Central District, and two patrolmen took charge 
almost immediately. 

The trouble arose from a misunderstanding about, the 
amount of wages to be paid. Spurgeon said that the 
agreement was $7 a week, while Amenda contended that 
it was $6. He was paid 85 cents, the amount for one day 
at the lower rate. He demanded $1. 

"I went into the restaurant with my knife open because 
I expected trouble," said Spurgeon last night. "I was 
mad, and when he started to push me towards the door 
I began to slash." 



238 



Editorial, 



JOHN ALEXANDER DOW1E, the new prophet Elijah 
and founder of the New Zion, before death was translated 
from the overseership of the Church of Zion to the realms 
of senility and dementia senilis, where the wicked cease from 
troubling and the weary are at rest. Here is the record o T 
his career. 

CHRONOLOGY OF DOWIE AND ZION CITY. 

Lands in San Francisco penniless, 1888. 

Locates in Chicago, 1890. 

Launches religious crusade, 1892. 

Wins a large following, 1893-1898. 

Buys site of Zion City, Sept. 3, 1900. 

Dedicates the city, May 30, 1901. 

Declares himself Elijah II., June 2, 1901. 

Spectacular crusade for "restoration" of New York, 
Oct. 14-Nov. 8, 1903. 

Zion City temporarily in hands of receivers, Nov. 24- 
Dec. 6, 1903. Shows statement of $14,000,000 assets over 
liabilities. 

Begins tour of world, Jan. 1, 1904. 

Visits Australia and returns through Europe, January 
to June, 1904. 

Announces Mexican colonization plans, May 22, 1905. 

Suffers stroke of partial paralysis, Oct. 1, 1905. 

Second stroke leads him to deputize overseers to care 
for Zion City, Dec. 19, 1905. Goes South for his health. 

Removes Overseer Speicher, Jan. 20, 1906. 

Reported dying in Jamaica, Jan. 29, 1906. 

Appoints Wilbur G. Voliva executive head of Zion City, 
Feb. 8, 1906. 

Said to have mortgaged his home and stable at Zion 
City, March 7, 1906. 

Zion Bank declines to honor his drafts, March 11, 1906. 
Overseers determine to ignore his orders, April 1, 1906, 



Editorial. 



239 



The whole ending in a receivership appointed by a 
civil court and the rational disposition and settlement, sees 
illusion, hallucination or delusion, of this modern miracle 
of folly. 

Truly the unstable neurone is abroad in the land, 
for other similar follies are yet alive and people termed 
sane embrace them. 

OHIO INSANE ASYLUM EX-EMPLOYES INDICTED. — 
The Athens, Ohio, County Grand Jury, Feb. 23, returned 
five indictments against former employes of the State Insane 
Asylum for alleged cruelties practiced against inmates of the 
institution. 

Three of the men were indicted for second -degree 
murder in "tramping out" an inmate. 

This is what should be done with men or women who 
strike the insane. Cruelty to the insane often comes of 
ignorant retaliation and a disposition on the part of some 
green attendants to display their physical powers. New 
attendants often do not realize that violent acts and foul 
insulting language of ordinarily apparently sane acting and 
speaking insane, are the outward expression often of some 
silent delusion. 

These violences suggest that only trained nurses should 
be employed to attend the insane and that every hospital 
for the insane should have its training school for attendants 
upon the insane who should be trained in the gentle hand- 
ling of these peculiar patients and in understanding of 
them and their claims to sympathy, tender care and exten- 
uation of wrong acts and speech. 

"He that would lay hand upon a lunatic 'save in kind- 
ness,' as he who would strike a woman, except when in 
peril and in self-defense, is a wretch whom it were base 
flattery to call a coward." 

The remedy for this evil and crime against humanity, 
is to train nurses for the insane and employ only such, 
paying them good wages and debarring the politicians from 
naming them. The day of the political management of 
insane hospitals is past, for our day and generation, of an 
awakened and active public conscience. 



240 



Editorial. 



TOXIC INSANOID STATES AND DELIRIUM WITH CON- 
SCIOUSNESS. CROTHERS in Vol. 28, No. 2, of his journal 
of inebriety, which is a journal whose aim is the promotion 
of sobriety, gives a number of instances well worth reading 
of what he is pleased to term unrecognized toxic insanities, 
a rather too broad a term perhaps for the clinical facts 
related, but the facts are worthy of record and study. 
Alienists know about them, but medical men in general do 
not always recognize them as they ought and even some 
alienists. 

These alcoholized brain conditions are insanoid states 
or delirium modified by more or less of consciousness. 

POOR OLD DR. DOWIE, says the Christian Register, 
"has gone the way of all the earth, and his deluded followers 
will gradually sink back into the mass of the populace, 
and be lost to view. Whatever property is left under the 
control of the church will, as in all such cases in the past, 
gradually become a trust, and finally disappear from public 
viev. Dr. Dowie was half-deceived, no doubt, in regard 
to himself; and he was wholly mistaken in his belief that 
his claims to inspiration and healing power were sufficient 
to give him such popular currency as Christian Science 
has had under Mrs. Eddy. He caught a multitude, but not 
the people at large. There was always to the general 
public something of the grotesque in his attitude and claims 
which made it impossible for him to win general confidence. 
Since time began men of this kind have arisen in such 
numbers that the world is never without a representative 
of the class. They will continue to come until common 
sense, one of the rarest of gifts, becomes universal," and 
let us add until that class of people that flies off at a neurotic 
emotional tangent, at every new "wind of doctrine" be- 
comes less in number than now, through a more trained 
stability of mind and brain beginning in the cultivation of 
neurone stability in school life and ab initio vitce, ante 
partem, at conception and before. When the clergy enjoin 
that what God has joined together let no man put asunder, 
let them be sure that God and not violated and perverted 



Editorial. 



241 



nature hath not through them, joined in God's name psy- 
chical and physical incompatables, the baleful point of whose 
conjugal union may not be psychic neurone instability and 
psychic caprice and even, in social, moral and religious 
affinities and conduct. 

AN OVER BRAIN STRAINED SIGNAL MAN BECAME 
INSANE, stopping the traffic on the Great Northern between 
Leeds and Bradford, England, for a time, but his insanity 
was fortunately discovered in time to avert great possible 
calamity. 

His wife thought he became unbalanced by overstudy 
on social and economic questions, but this was simply the 
direction his over-worked mind took as he was breaking, 
these questions of the day being in the line of his intel- 
lectual taste. Men must think about something. He is 
said to have been a man of exceptional thoughtfulness and 
knowledge, for .his station, on social and economical subjects, 
believing he had a divine call from work. 

The man went mad suddenly in his box, but fortunately 
set all the signals at "danger" before deserting it. He 
locked the door at midday, walked down the line, and told 
a plate layer that God had commanded him, in a vision, 
to go out and preach the gospel to all the world. 

The laborer paid no attention to him, thinking he was 
joking, and Storey went on till he came to another signal 
box. There he repeated his story to the signalman, who 
promptly wired to the stationmaster at Laisterdyke. 

In the meantime about a dozen trains had drawn up 
on the line near Laisterdyke, and the wildest rumors began 
to circulate among the passengers. A new man was put 
in Storey's place and the line was quickly cleared. Brain 
disorder in its prodromal state should be looked for as well 
as color blindness, and guarded against by railway officials. 

THE STRENUOUS UNRESTFUL LIFE of railway engi- 
neers has many untimely endings like the following though 
not in precisely the same way. When will the right influ- 
ence of the medical profession be felt and good financial 



242 



Editorial. 



sense as well as right charity toward employes, prevail 
among railway managers? 

The brain has its limits of endurance beyond which it 
can not go, as the less delicate machinery of man's con- 
trivance. Over-tired brains are dangerous at the throttle or 
the keyboard. In this instance it destroyed the engineer. 
In others it destroys the trustful travelling people. 

"J. F. Dunn, an engineer on the Illinois Central Railroad, 
on the fast train between East St. Louis and Carbondale 
for sixteen years, committed suicide Saturday night in his 
room at Carbondale by taking cyanide of potassium. 

"Dunn and his brother-in-law, Charles Wright, who 
had been acting as his fireman, retired at the end of their 
run Saturday night, and Dunn, who had been despondent 
for a week because of an accident to his engine said he 
would take some medicine and go to bed. 

"Wright soon knew that Dunn had taken poison and 
summoned a physician, but to no avail." Not suicide, but 
brain strain self-destruction. 

INADEQUATELY QUALIFIED PSYCHOLOGICAL EX- 
PERTS — In the criminal jurisprudence of insanity one of the 
gravest dangers of the day is the acceptance by the courts 
of witnesses as experts who are inadequately qualified 
because of insufficient clinical experience or profound study 
of the subject. In questions of homicidal insanity, medical 
fools, with scarce a scintilla of proper qualification may 
always be found willing to rush in and testify as experts, 
where the angel of an honest conscience and the counsel 
of a properly trained judgment and experience would fear 
to tread. Such medical men see in any extreme mental makeup 
of conduct and brutal violence which would not be possible to 
themselves, evidences of insanity and boldly so testify and 
characterize as insanity only, that which is heartless or reck- 
less violence. Their criterion is simply their inner conscious- 
ness and not experienced observation ; what they imagine 
ought or ought not to be. They offer this under their solemn 
oath as experience founded expert opinion. 



Editorial. 



243 



And alas for justice, and the welfare of communities 
and the moral progress of society, learned judges often 
admit and sustain as legal evidence such ill-founded and 
usually erroneous medical guesses which then pass as legally 
scientific opinions. Under such wrong proceedures the 
innocent, by judicial connivance, are often hung, while the 
guilty as often go free. 

Great crime is thus sometimes condoned by immunity 
from the righteous vengeance of the law and innocence is 
ma ie to suffer its direct penalties. Dishonest or consciously 
ignorant expert medical testimony is perjury. 

THE FARCIAL TRIAL of Thaw's sanity before a 
mixed commission, such as the New York law sanctions for 
determining the question of mental disease or mental 
soundness, by asking Thaw only such questions as bear 
upon his capacity to advise rationally with his counsel, is 
coram non judici, and ought to be so declared by revision 
of the New York statutes. 

INSANITY IS A DISEASE for doctors to decide by some- 
thing more than asking questions, and by asking questions not 
subject to limitation by the court. Thaw should have been 
questioned as to why he shot White, and as to the time and 
place and the manner 'he did, and what he thought about 
the dead now and thought then, and why he did not have 
White indicted instead of killing him, and how he felt and 
thought about the deed after, at the trial and before. 

A personal examination by medical men for all possible 
objective symptoms should have been made medically of a 
patient as to insomnia, constipation and other symptoms, 
as any other person afflicted with a similar disease 
would be. If the question is not one of possible mental 
disease, physicians should have nothing to do with it; if it 
is a disease, the question of mental disease diagnosis is 
beyond a lawyer or a layman's province. The latter should 
not have been on a medical diagnosis commission. A com- 



244 



Editorial. 



missio de lunatico inquirendo should be one of medical men 
only, employing medical methods of examination without 
restriction through order of judge, or of objection from attor- 
neys. Insanity is a medical question. Mental soundness or 
insanity is a medico-psychological question. 

"'BRAIN STORMS, THE 'EXAGGERATED EGO/ A 
LAYMAN'S VIEW if it is a mark of insanity, did not leave 
much of the insanity in or out of the Thaw case unex- 
plained. Now another expert has covered everything that 
was left with the 'brain storm.' 

"What juries are expected to believe is that people 
with exaggerated egos who have brain storms, are not re- 
sponsible for their actions. But the history of this coun- 
try and of every other is wholly contrary to that theory. 

"History shows that most of the trouble in the world 
has been caused by people with exaggerated egos, who de- 
liberately formed the habit of having brain storms as a 
method of having their own way. 

"They discovered that their symptoms of brain storm 
are terrible to the timid. The storm might have been 
genuine at first, but they learned to have it at their own 
convenience, until it became a fixed habit of their exagger- 
ated ego. Then it is 'automatic' They have it whether 
it is convenient for their own purposes and comfort or not. 

"This was known to Darwin. It interested him greatly. 
He studied it all the way down to the large, green cabbage 
worm, which after its "ego" becomes highly exaggerated 
by its rich diet, has a habit when interfered with, of swel- 
ling up and "looking terrible." It is really harmless, but 
its photographs, taken and published in various scientific 
works, show that when it is having one of its stomach- 
storms, it looks more dangerous than a rattlesnake. 

"A great step forward was made when it was found 
that by locking up people with exaggerated egos and 
teaching them the soothing rythm of the lockstep in going 
to and from useful labor, their habit of having brain storms 
can be relieved. This opens the way for indefinite 



Editorial. 



245 



progress in spite of the exaggerated ego —Post -Dispatch, 
March 6, 1907. (The exaggerated ego of insanity is a dis- 
ease engendered egoism. ED.) 

THE PARATERESEOMANIAC might have his mind occu- 
pied to exhaustion with seeing new sights of gigantic sky- 
scrapers just now going up in St. Louis, of many styles of 
architecture and designed for many different uses. 

ONE OF THOSE EROTOPATHIC WOMEN, such as are 
prone to fix upon doctors, divines, lawyers or other men of 
growing prominence as their legitimate, erotic prey, is re- 
sponsible for the recent death of a leading, most reputable 
physician of a nearby city. Going to the doctor for treat- 
ment, and these women are always neuropathic as well as 
psychopathic with neurogenital erethism, she became im- 
portunate in requiring the doctor's attention by frequent 
telephone calls, and needless, until as is usual in such 
cases, the doctor protested and complained. The matter 
culminated in what appears to have been a jealous eroto- 
pathic engagement announcement by the lady, either under 
nymphomaniacal delusion or from nymphomaniacal design, 
to circumvent a possible engagement to another on the part 
of the erotopathically victimized doctor. The killing of the 
doctor by the disease dominated woman, and her own 
suicide at the same time and by the same means resulted. 
She shot the doctor and herself. 

These morbidly erotic women should have female doc- 
tors, but they will not accept them when you suggest 
them, and there are not as yet a sufficient number of 
capable lady neurologists, who could rightly manage them 
if they would. 

The only possible promise of freedom from annoyance of 
the male physician from these persisting erotopaths, is a freely 
opened and cleansed prima via and an anesthetized psy- 
chogenital tract, much as if treated for epilepsia, putting 
hyperesthesia and hyperkinesia in abeyance. The female 
erotopath in the physician's office is an annoying menace 
to the peace of mind of the medical practitioner as she is 
also often to priests, clergy and other men. 



246 



Editorial. 



EVELYN THAW AND HER DRUGGED DRINK? — Mrs. 

Evelyn Nesbit Thaw, in giving the details of her drugging 
at the hands of Stanford White, said that within two or 
three minutes after she had taken the glass of champagne, 
with the drug in it, she lost all consciousness. Now chloral 
hydrat in a full dose upon a specially susceptible person 
may act very briefly. Sitting at the bedside, I have been 
surprised often at the exceeding rapidity of its sleep- 
inducing effect in a thirty or twenty-five grain dose given 
largely diluted. I have seen a patient under such a dose 
pass into sleep within five minutes of its administration, 
just as if from a full 3/100, not abortive dose of hyoscine 
hydrobromate. 

A patient's own estimate, however, of the time re- 
quired to produce sleep is modified by the drug's influence, 
and would be much like the estimate of time in normal 
dreams. 

THE SPREAD OF THE IMPULSIVE INSANITY IDEA. 
"Nifty in the Noodle." — An Irish criminal prisoner, fifty- 
four years old, defending himself before the Court of Crim- 
inaj Correction, St. Louis, against a charge of petit lar- 
ceny, and acting as his own attorney and proving that he 
had a fool for a client, plead that he was emotionally and 
impulsively insane, "nifty in the noodle," as he expressed, 
and "couldn't help the theft." On this ground he 
asked the lenient judgment of the court, so that his friends 
might come to his rescue and pay his fine, which he con- 
sidered ought to be moderate, in view of his over- master- 
ing mental affliction. 

Judge Taylor was evidently touched with the ' nifty - 
noodled" prisoner and, in charitable extenuation for his 
remarkable mental affliction, made the fine five dol- 
lars. 

"Nifty in the Noodle" is a rather new term to alien- 
ists for kleptomaniac psychokinesia, but it meant the same 
to Mr. Murphy, at least Murphy meant to piease and pla- 
cate his honor, the judge, with this plea, for no criminal 
lawyer could make plea of insanity couldn't help it, more 



Editorial. 



247 



resistant for his client than the same pauper criminal, who 
probably stole like Judge Baldwin's pig- stealing client, in 
"self-defense," of the gastric necessities of his hungry life. 

OPIUM-BROMID TREATMENT OF EPILEPSY. — Kellner 
has treated 85 epileptics at the Alsterdorf asylum for idiots 
and epileptics with a special course of opium and bromid, 
which has resulted, he states, in the cure of 2-2 of 
the 54 patients who completed the course. In 13 others 
the seizures have become very much less frequent and less 
severe, with intervals of several months and without con- 
tractions. Only 6 patients failed to profit by the treat- 
ment. He gives for 50 days 0.05 gm. extract of opium 
three times a day, increasing gradually until the maximum 
of 0.29 gm. is reached the fiftieth day, the next morning 
0.3 gm. is given and the opium discontinued. He then 
commences with 2 gm. of a mixture of one gm. each of 
potassium bromid and sodium bromid with half a grain of 
ammonium bromid, taken in a glass of fresh seltzer water. 
This dose is taken at noon and again at night from the 
fifty-first to the fifty- eighth day, gradually increasing it 
to the maximum of 9 gm. daily, which is continued for 
months. During the course of opium he gives three times 
a day a tablespoonful of 1 per cent, solution of hydro- 
chloric acid, and Carlsbad salts at need, with a light and 
predominantly vegetable diet, and a daily bath at 24 C. 
(75 F.) for 10 minutes the first day; 23 C. for 9 minutes 
the second day, and so on to a bath of 17 C. (62 F.) for 
3 minutes the eighth day, repeating this without change 
for a week and then lengthening the bath by one minute 
until the maximum of 6 minutes is reached by the end of the 
50 days of the opium course. The above dosage is for 
otherwise healthy adults. — Munchener Medi&nische IVochen- 
schrift. 

We give this place to condemn the opium in this method. 
Bromides and brain support, with autotoxine elimination 
without opium, will do fully as well in results. Epileptic 
suppression and cure are different. Time must elapse before 
you may know as to cure and, in a chronic trouble, such 



248 



Editorial. 



as epilepsy is, the long continued use of opium is unwise 
therapeutics. 

The success is in the full dosage of the bromide. All 
the results above may be secured without the opium and 
better with mercurials alternating with salines, whether 
Carlsbad or Epsom, etc. 

■ REFUSING EPILEPTICS TABLE SALT in their dietary 
appears unwise therapeutics, in view of the now plausibly 
established autotoxine and ptomaine conception of convulsive 
excitation therefrom, and the well-known antiseptic and 
antitoxic power of ingested chloride of sodium in minimum 
quantities. 

AN EXTREMELY YOUNG GIRL SUICIDE trying to 
form a suicide compact with another schoolmate, was 
discovered in St. Louis, March the fifteenth. 

The child was eleven years old, and bought and swal- 
lowed a dime's worth of carbolic acid, unlawfully sold to 
her by a thoughtless and law-defying drug clerk, who 
knew the law required a written order for minors. 

. Neurotic instability is quite as apparent here as in 
some of the recent cases of unwritten law psychopathy, 

DR. CLARENCE MARTIN, of St. Louis Mo., has re- 
cently acquired the Medical Mirror and consolidated it with 
his own journal, the Medical Era. The Medical Mirror, 
the journal of the late lamented and talented Dr. I. N. 
Love, had a prosperous and successful career, and was one 
of the best known medical journals in the country. By 
consolidating it with the Medical Era the usefulness of the 
Era will be enlarged. The April issue of the Medical 
Era, the first number of the consolidated journals, and full 
of interest, is before us. 

We wish continued and increased prosperity to the 
Medical Era under the consolidation. 

THE TETANIC AND SEPTIC DANGERS OF GELATIN. 
A Government Note of Warning. Dr. Harvey W. Wiley, Chief 



Editorial. 



249 



of the Chemistry Bureau of the Government Agricultural De- 
partment testifying to the deterioration of cold storage food- 
stuffs, says that the Marine Hospital Service found tetanus 
germs in gelatin; that gelatin is made from the scrapings 
of hides "that smell to heaven" and that the gelatin 
factories are exceedingly dirty. He reminds us that our 
capsules, as well as deserts and candies, are often made 
from gelly. 

While these facts are not specially new, and are rather 
sensational, and while the treatment of hides with alkalies 
to prevent decomposition is proper enough, it is well to re- 
peatedly arouse the public to the importance of aseptic 
food factories, packing houses, and especially, clean- 
habited and disinfected workmen. Filth and food ought 
not to be mixed. 

THE CHILD'S PHYSIOLOGICAL MAGNA CHARTA— 
What Robert Rentoul in his latest work terms the "Chil- 
drens' Magna Charta" is the birthright to be born physi- 
cally and mentally healthy, the birthright to be happy, 
the birthright to be useful citizens and healthy parents. 

To secure these rights, sacred, saving and inalienable, 
society and the state should suppress the chronic brain 
disease engendering inebriate, as chief among the victims 
of the vicious neurone degeneracy or prevent his having 
progeny doomed to defect and misery. It should sequester 
the idiot and all congenital mental defectives and stop 
promoting the propagation, through lawfully authorized mar- 
riage of the degenerate, of abortive brains that handicap 
the creature, the state and society. 

Babes and children yet to be 
And grow to place among mankind, 
Have right to be, by traduction free, 
Of taint of blood or taint of mind, 
Science rightly enjoins the way 
And true charity should obey. 

(C. H. Hughes.-) 



250 



Editorial. 



THE PUBLIC CONSCIENCE is now being aroused as 
to political and combined capitalistic criminality and the 
wrongs of organized greed. It must be aroused as to the 
crimes against the human mind and its normal integrity 
and against the causes, which engender defective and degen- 
erate organisms unfit for the requirements of civilized life. 
Lives like some of those of the "tenderloin bunch" and trag- 
edies like the White murder and lives like those of Thaw, Gui- 
teau and others who live on the paranoiac border line or in 
the swim of paranoia with paroxysms of psychlampsia and 
brain-storms, should be lived amidst judicious lawful sur- 
veilience. 

THE UNSTABLE PSYCHIC NEURONE, fearful, fatal, 
though also often only injudicious, whose instability is repeat 
edly brought to light anew to the Alienist and Neurologist, in 
the records of the daily press and in the writings of some 
of the daily press reporters to whom life seems to be only 
a series of abnormal psychic sensations and explosions, who 
seem to be troubled with a pathopsychokinesiac calamus 
scriptorius, has been justly made the subject of judicial 
strictures from the New York and Chicago courts. 

The Yellow Press sensationalists are doing the brains 
of the people no little harm by the way they dish up and 
promulgate the news of crime, the doings of criminals 
and the divorce court proceedings. The vaudeville and 
lower class of amusement caterers and the libidinous bill 
boards, are doing enough to promote neuropathic insta- 
bility and depravity and develop a morbid erotism among 
the people, without the powerful assistance of an over- 
sensational Press in facilitating psychic decadence among 
the people. 

It is pleasing however to note that some antidotal 
influences are at work in the better class of newspapers. 
In this connection we take pleasure in noting salutary 
reformatory and vicariously atoning efforts of the Press of 
St. Louis. 

The daily Press should endeavor to be more discreet 
in its sensational selections and act more on the side of 



Editorial. 



251 



sound morals and a sound, stable, self-governing psychology, 
with a view to strengthening rather than unstabling brains 
of an already (crime, pleasure and excitement) overwrought 
people. These United States have political duties now and 
the destiny before them demands and will demand steady 
brains and strong, as well as aims to answer great demands. 

DR. PERRY ON THE PATHOLOGY OF DIABETES at 
the Portugal Congress gave great and just prominence to 
the neuropathic element in this disease, a view in advance 
of former deliverances on this subject which has almost been 
in a measure the author's life work, a view advanced many 
years ago by the editor of this journal. The time is fast 
approaching when neurology will reign paramount in medical 
thought, as announced when the Alienist and Neurologist was 
founded in 1880. See editorial of initial number and volume. 

HYSTERICAL STIGMATA IN COURT.— A curious use 
of science was made in the St. Louis courts * * to explain 
what were alleged to be "knuckle marks" made on the 
person of one woman by a blow from another. It was 
alleged on expert testimony that they might have been 
"stigmata" due to the effects of highly wrought imagina- 
tion. Something over twenty years ago experiments were 
made in the "Charcot School," in Paris to find the possible 
effects of the imagination on the body. It was alleged in 
the reports of such experiments at the time, that a woman 
of highly nervous temperament was blistered by a wet rag 
on her back which she was made to believe was a mustard 
plaster. When these results of science are brought into 
court in Missouri, Missouri justice is entitled to know full 
details of every scientific step involved. But an important 
point in the testimony is the acknowledgment of physicians 
and scientists of the power of mind to create or modify 
conditions of the body. This field of research has scarcely 
been touched as yet, although its vital bearing upon 
health and upon the cure of disease is admitted. Science, 
instead of seeking the whole truth, is inclined to sneer at 



252 



Editorial. 



those who assert the discovery of truth in this field. — St. 
Louis Republic, March 3, 1906. 

As the alienist and neurologist expert in this case we 
have to say that stigmata were described as one of the 
possible symptoms of hysteria. The defending lawyer 
made the application to explain to the jury what he 
claimed as a delusive occurrance unsupported by other than 
the complainants' testimony. 

Physicians have never doubted the minds' influence 
over the body in disease. Their injunctions to nurses and 
all who come in contact with the patient is not to impair its 
influence and resistance by depressing- demeanor or speech. 

The terms known to neurological medicine such as sug- 
gestive therapeutics, psychiatry, etc., are standing confirma- 
tions. It is the exclusive use of faith to the ignoring of natural 
methods and in l,ieu of experience that general medicine 
condemns. It regards medication as essential as diet, sun- 
light, air, sanitary surroundings and mental rest and hope 
in managing disease. 

The rational helps and supports of nature and sugges- 
tions of experience are as essential to the cure of disease, 
as the teachings of experience in eating, clothing, navigation 
or business' management or as keeping a hotel. 

The "bless me this is richness" plan of Dickens' 
"Dotheby's Hall" does not always sustain bodies any better 
than it cures disease, with all people, though it may work 
on public credulity for awhile. 

The hopeful spirit of Mulberry Sellers is not to be 
discouraged in ministering to the sick, if the patient pos- 
sesses it. Cheerful optimism is always an aid to 
medical ministration, if the patient does not omit his medicine 
or take too great chances with adverse environment. But 
as faith is not a good substitute for physic when the bowels 
need a purge, it is not a good exclusive alternative for other 
physical states that need medication. 

INTERNATIONAL CONGRESS ON PSYCHIATRY, NEU- 
ROLOGY AND PSYCHOLOGY to be held at Amsterdam, 
2nd-7th, September, 1907. At its meeting held on July 



Editorial. 



253 



24th, 1903, The Netherlands Psychiatry and Neurology 
Society unanimously decided to organize an International 
Congress on Psychiatry, Neurology, Psychology and the 
Care of the Insane. 

The eminent position, which the study of nervous and 
mental diseases to-day holds in the sphere of Medical 
science, and the great social interests, bound up in a com- 
plete knowledge of all the psychical manifestations of man, 
render it imperative (in order to afford scope for an inter- 
change of opinions) to have recourse from time to time to 
a wider and more specialized field than can be found 
in the narrow confines of sections of a General Medical 
Congress. 

While admitting the great importance of National Socie- 
ties for the study and development of Psychical and 
Neurological Science, it is incontestable that International 
Congresses are unique in their facilities for the complete 
examination of modern science and for the international 
collaboration, which is indispensable to the real progress 
of Science. 

In the organization of the projected Congress the tradi- 
tions of the Congresses at Brussels and Paris have been 
followed. It is thought, however, that the importance of 
the Congress will be enhanced by the introduction of a 
section for Psychology, which by reason of its influence 
on our conceptions and methods of psychical examination, 
is entitled to occupy a prominent position at any Congress, 
dealing with the different manifestations of Psychical Life. 

It will be endeavoured as regards the section of The 
Care of the Insane, to follow in the footsteps of the Con- 
gresses at Antwerp and Milan. 

We thus earnestly solicit your attendance on our Con- 
gress, which will be held in Amsterdam, 2nd-7th, September, 
1907. Under the Patronage of Her Most Gracious Majesty 
the Queen Wilhelmina and of His Royal Highness Prince 
Hendrik of the Netherlands. Honorary Presidents: H. E. 
The Minister for Home Affairs, Dr, P ? Rink, H. E. The 



254 



Editorial. 



Minister of Justice, Dr. E. E. van Raalte; Dr. G. van 
Tienhoven, Commissary of Her Majesty the Queen in 
the Province of North Holland. Dr. W. F. van Leeuwen, 
Burgomaster of Amsterdam. 

International Propaganda Committee for the U. S. A. 
are as follows: 

New York: Drs. Carlos F. MacDonald, William Mabon, 
Charles Pilgrim, M. G. Schlapp, W. B. Pritchard, and 
Louise G. Robinovitch. 

Philadelphia: Drs. S. Weir Mitchell, John K. Mitchell, 
Charles K. Mills and W. G. Spiller. 

Providence, R. I.: Dr. G. Alder Blumer. 

Boston (Cambridge,) Mass.: Prof. William James. 

Madison, Wis.: Prof. Joseph Jastrow. 

St. Louis, Mo.: Prof. C. H. Hughes. 

Chicago, III.: Prof. Hugh Patrick. 

Montreal, Canada: Dr. T. Burgess. 

CHRISTIAN SCIENCE HAS A RIVAL in remarkable 
cures in a certain brand of whiskey, testimonials to the 
virtues of which may be seen in all of the daily papers, 
of people rescued from the doctors and undertakers by the 
hundreds, especially in the resussitation of old people rescued 
from the grave through its virtue and power. Some of 
them will probably live till they are translated under its 
inspiring spiritual influence. They will go on getting better, 
like the man with the fractured and shortened thigh under 
absent Christian Science treatment, whose leg began to 
grow and kept on growing till it made the other leg look 
short, because he lost the name and address of the scien- 
tist who started the miracle. 

CHOREA CONSIDERED AS A NEUROHUMORAL DIS- 
ORDER — Read at the Portugal International Congress by 
Sir Dyce Duckworth, a paper on "Chorea considered as 
Cerebral Rheumatism," in which he concluded: 

1. That chorea (of Sydenham) is now regarded as a 
disease caused by an infective agency, and not as the 



Editorial. 



255 



result merely of shock or fright occurring in persons of 
neurotic instability. 

2. That the peccant matter of rheumatism, which is 
now recognized as of microbic origin, is certainly the most 
frequent if not the sole cause of the infection. 

3. That no other microbic element than this diplococcus 
has been discovered in those cases of chorea which are 
believed to be unconnected with rheumatism and independent 
of rheumatic influence. 

4. That the infecting agent appears to be somewhat 
akin to but distinct from other varieties of streptococcus 
which induce ordinary forms of pyasmia. 

5. That chorea is therefore to be regarded as a form 
of rheumatism involving the membranes and cartical struc- 
ture of the brain, and is in fact cerebral rheumatism. 

6. That there is a neurotic element in the pathogeny 
of chorea predisposing subjects thus impressed to this man- 
ifestation, amongst others, of rheumatism. 

7. That chorea is thus a neuro-humoral disorder." 
Whatever be the relation of the diplococcus infection 

above referred to there is no doubt in our experience of the 
depressing and exciting cause on influence of psychic shock. 
Too many well proven instances have come under our 
personal observation and recovered under neurotic tranquili- 
zation and reconstruction treatment without anti- rheumatic 
treatment to permit us to doubt the prime importance of 
the element of cortex-instability in the functional display 
of this disease. ED. 

THAW'S INSANOID MORBID EGOISM — We may not 
say, in the hearing of the court, paranoiac morbid egoism, 
for though able experts have called Thaw a paranoiac, 
others have denied the paranoia and the jury of two laymen 
and one doctor have pronounced him sane. Real paranoiacs 
seldom, if ever, recover except in outward appearance. We 
must therefore improvise a new term — paranoiad (like para- 
noia) as paranoia is so near, so like other forms of insanity 
and yet so different, so like the folie raisonante, itself so 



256 



Editorial. 



like sanity, because its victims can reason, that it was for 
long disputed till the Germans found this latter term for 
this very similar condition. 

Paranoiacs are always ready under stress of strong or 
slight exciting influences, to display the innate latent psycho- 
kinesiac aptitudes and slumbering tendencies to imperative 
conceptions and fulminations, breaking the monotony of 
quiescent delusion and abiding morbid mentality, in revealed 
mental disease when and where not looked for by the non- 
expert. 

The startling psychlampsias of paranoia and paranoid, 
like the morbid brain-storms of other cerebro-mental 
diseases, serve to show insanity, as the lightnings in the 
approaching cloud serve to show that electricity is in the 
atmosphere. 

MINIMUM AND NON-ALCOHOL PRESCRIBING re- 
ceived much proper consideration at the late meeting of 
the British Medical Association. The medical profession has 
had its day of intemperance in prescribing the alcoholics, 
as was there clearly shown in the addresses of Victor 
Horsley and others. 

Intelligent people likewise, appear to have had their 
day in the intemperate drinking of alcoholics, and the tide 
of liquor drinking among the well-informed is ebbing. Alco- 
holics unwisely prescribed are as much a mockery in re- 
sults as when unwisely imbibed. 

THE WITH INTERNATIONAL MEDICAL CONGRESS at 
Budapest in 1909. — The XVth International Medical Con- 
gress, held in Lisbon, have chosen Budapest, the capital and 
residence of Hungary, for the site of their next assembly, 
and the preliminaries are already in process. 

His Imperial and Apostolic Royal Majesty the King has 
graciously taken upon himself the patronage of the ensuing 
congress. The state and town have each contributed 
100,000 crowns to defray the expenses. 

The committee for the organization, execution, disburse- 



Editorial. 



257 



ments and reception, as also for the sections is already 
formed and the statutes are drawn up. 

There are 21 sections, each branch of science having a 
separate section assigned to it. 

The date of the opening is fixed for the 29th August 
1909, and the sessions will be continued till the 4th of Sep- 
tember. 

There is every reason to presume that the congress 
will be well attended. Hitherto they have shown an at- 
tendance of from 3000 to 8000 participants. Judging from 
the geographical situation of Budapest, at least from 4000 
to 5000 participants may safely be reckoned upon. 

The managers of course, attach the utmost importance 
to the scientific activity of the congress, and every effort is 
being made to win over the most prominent representatives 
of medical science. 

The first circular, which will contain every necessary 
information as well as the statutes, will be ready for circu- 
lation in the course of the year 1907. Meanwhile the 
Secretary- general of the congress (16th International Medi- 
cal Congress, Budapest, Hungary, VIII., Esterhazy-utcza 7), 
will have much pleasure in giving information to inquirers. 
Emil Groz, M. D., Professor to the University; Secretary- 
general of the Congress. Caiman Muller, M. D., Profes- 
sor to the University, Member of the House of Magnats; 
President of the Congress. — Budapest, March 1, 1907. 

THE CINEMETOGRAPH DEMONSTRATION of various 
forms of Epilepsy, Athetosis and other nervous diseases by 
Dr. Chase, of Boston, before the Portugal Congress and 
the last meeting of the American Medical Association at 
Toronto is a novel and excellent method of showing symp- 
toms of spasmodic diseases, and a great help in certain 
clinical lectures, as on epilepsy, for instance, where the 
subject fails to make a timely demonstration for us. 



258 



bditorial. 



A RARE NOTE OF THANKFUL OBLIGATION FROM A 

RARE ATTORNEY. 
DR. C. H. HUGHES, 

3872 Washington Blvd., 

City. 

Dear Doctor: — 

Herewith we hand you our check as 
agreed, in full payment for your professional service ren- 
dered as expert in case of , et al. 

Kindly send us receipt, and permit us 
here and again to express our appreciation of your patient 
willingness to enlighten the ignorance of, 

Yours truly, 

^ * ^ 

This sense of obligation to a psychoneurological expert 
is rare. The diligent inquiry of the attorney before the 
trial as to the essential facts to be proved in order to es- 
tablish the nervous disease existing, is exceptional. 
Usually the medical expert has to thrust his knowledge 
upon the attorney and insist on a certain line of diligent 
inquiry in the right line of testimony, and upon the line of 
questions to ask, and on showing the answers, in order 
to awaken the lawyer to a full realization as to what to 
do in order to establish disease. Too many await possible 
developments on the days of the trial. 

PUBLIC RECOGNITION OF MEDICAL MEN comes 
grudgingly on strictly medical lines. He may bring to light 
and put back "the pestilence that walketh in darkness and 
stay the destruction that wasteth at noonday," and his good 
work is too often overlooked or accepted as a matter of course, 
as the dishes of a cook are received or the work of any 
servant. 

But when a medical man steps aside into literature 
and makes a mark, as many do, and more could, it is 
noted. 

Weir Mitchell's fiction has made him more fame with 
the public than all his valuable facts contributed to neuro- 
logical science, and so with Oliver Wendell Holmes. He 
discovered the contagiousness of puerperal fever and con- 



Editorial. 



259 



tributed thereby to the saving of thousands of human lives, but 
Autocrat of the Breakfast Table alone gave him far more 
fame than that. And so we hear of Brunton, Conan Doyle, 
Hammond and others. Yet as a contemporary of Mitchell, 
Bartholow, Sequin, Amadon and others, the latter contrib- 
uted his share to medical discovery and resources in the 
field of neurology. 

If a medical man imprudently ventures into literature, 
while yet aspiring for patronage in practice, he imperils 
his professional reputation and there are not wanting 
those in the ranks of his guild who will uncharitably say 
"he is a good writer, but not much of a practitioner, " as 
though a competent medical man could not fit himself for 
forceful thoughtful expression on matters of human concern, 
as well as wear good clothes and rightly-fitting on his 
frame. 

The medical man who well and rightly sees and 
thinks and speaks concerning his profession, should neither 
be blind nor incapable concerning the rest of his environ- 
ment. The observant , well-educated physician is well in- 
formed in the collateral sciences and should be the broad- 
est of anthropologists. 

THE BLOOD PRESSURE IN CASES OF PARETIC 
DEMENTIA. — The preponderance of opinion inclines toward 
the view that the pressure is low in the later stages of the 
disease, although the evidence adduced is not altogether 
conclusive. With the view of determining this point on 
the basis of personal knowledge, Dr. G. L. Walton (Journal 
of the American Medical Association, October 27, 1906, p. 
1341) made an examination of 108 male patients, and he 
has found that the average blood pressure in cases of 
paretic dementia is on the whole high, probably as a result 
of atheroma and its cardiac and renal accompaniments. On 
the other hand when atheroma, cardiac enlargement and 
renal disease are absent the average blood pressure appeared 
to be somewhat lower than that of health, although the 
variations were so marked that the pressure could not be 
said to be uniformly low. Accordingly it will be seen that 



260 



Editorial. 



this test is not likely to prove of great value in the differ- 
entiation of paretic dementia from other disorders of the 
nervous system. The observations tended further to indicate 
that the excited states of paretic dementia are as likely to 
be accompanied by high as by low pressure, that mental 
depression is accompanied by high oftener than by low 
pressure, although it is not incompatible with a low pres- 
sure, and that while the average pressure in the presence 
of euphoria is perhaps somewhat lower than in the presence 
of other mental states accompanying paretic dementia, it is 
not inconsistent with high blood pressure or with pronounced 
atheroma, with its cardiac and renal accompaniments. — 
Editorial, Pennsylvania Medical Journal, January. 

A RIGID AND RIGHT INVESTIGATION of the late ter- 
rible' collision disaster at Terra Cotta Station, near Washing- 
ton, D. C, would probably reveal a wearied, not well-acting 
brain, from too little sleep. Maybe with drink-weariness 
added, a custom too common to the season with men who 
have life-caring duties to perform, or loss of sleep and im- 
paired powers of attention from other cause. 

Nearly every investigation of every railway accident in- 
quires into the question of sleep. It should be known if the 
inspector of wheels and brakes and trucks has had the 
sleep he needed, and if not, why. 

On the engineer and the train dispatcher depend such 
consequences to life that the hand that moves the throttle 
and sends train -moving or detaining dispatches, should be 
the highest style of man, with mind capable and alert to 
the importance and means of keeping at all times a clear, 
strong head and mind for unerring work, and he should be 
treated accordingly by himself in all his habits of life and 
by railway management. Treated right as to tax on their 
vitality and liberally as to salary for such important 
service. 



16,937 RAILWAY CASUALTIES, 194 directly caused rail- 
way deaths in three months in the United States for the 
quarter ending June 30th, 1906 and 274 deaths for the pre- 



Editorial. 



261 



ceding quarter, and almost a like number for the following 
quarter, suggest the need of a rigid official inquiry and 
remedy, not only into the safety of railway construction 
and equipment, but into the mental condition of the man- 
agement and men that make such enormous maiming and 
death lists possible. 

Mental inadequacy and moral obliquity must be largely 
to blame for such horridly inhumane and fatal railway 
management. Weak brains, over-wearied and worn brains, 
wrong thinking and wrong feeling, inhumane brains, with 
avarice, fiendish dividend-making and greedy charity-killing 
brains, dollar-saving, life-destroying brains, overworked and 
overborne brains are too much in evidence in our railway 
management and service for the good of humanity, espec- 
ially that part which goes to make up the railway suffer- 
ing and destroyed American people. 

NOW IT IS THE PRESIDENT, the corypheus of the 
strenuous life, who has reached the result of ceaseless 
cerebro-psychic strain and approached so near the verge of 
grave cerebrasthenia that he is to take a timely rest at 
Oyster Bay, with a very quiet domestic program arranged 
for him there, if he can be permitted to carry it out, which 
would seem scarcely a possibility. 

A visit incognito to Alaska or to Iceland, or a long sea 
voyage beyond the reach of news even by wireless aero- 
gram, would have been and would yet be best. Presidents 
need brain rest like other mortals and should cultivate, 
through adequate, quiet retirement and relaxation, that re- 
cuperation of psychic neurone stability which gives the 
mental poise and equanimity and freedom from the neurone 
irritability of cerebrasthenia so essential to the brain of the 
chief executive of a people, who kill presidents by over- 
work demands upon them, as well as by direct assassina- 
tion. 

His excellency may perhaps be now blissfully thinking 
some of the things Pope said in his farewell to London: 

"Dear, D , distracting town, farewell, 

Thy fools no more I'll tease; 
Now in peace let critics dwell 
And pitchforks rest at ease." 



262 



Editorial. 



A JUST COURT DECISION. HOT WATER IN EAR IS 
"EXTERNAL " INJURY, RULES THE COURT.— Last March 
the Kansas City Court of Appeals decided that the chance 
injection of scalding water into a man's ear was "An 
accidental, violent and external injury." 

John D. Driskell died from the effects of scalding 
water dripping into his ear from an engine around'which he 
was working in the Missouri Pacific shops in Sedalia. 

He held an accident policy in the United States health 
and accidental insurance company, but that company re- 
fused to pay the policy upon the ground that an injury 
from the dripping of water in the ear was not an external, 
violent and accidental injury. But the appellate court de- 
clares that it is. The case is sent back to Pettis county 
for trial. 

AMERICAN MEDICAL EDITORS' ASSOCIATION.— The 
38th Annual meeting of this Association will be held at 
Atlantic City on Saturday, June 1st, and Monday June 
3rd, with Headquarters at the Marlborough- Blenheim Hotel. 
This active Association now numbers nearly 150 members 
with many applications in hand for action at the coming 
meeting. An interesting programme has been prepared. 
Besides the President's address many valuable papers will 
be read. It is anticipated that the coming meeting will 
exceed any prior meeting in point of attendance. 

The Annual Editors' Banquet, the social event of the 
week, will be held at the Marlborough- Blenheim Hotel on 
Monday evening, June 3rd. 

DR. HERMAN A. SANTE married to Mrs. Mary A. Sante 
ought to prove a healthy union in the salubrious climate of 
St. Louis. Bon Sante, doctor and Mrs. Sante. 



IN MEMORIAM. 



DEATH OF THEODORE BUHL.— The great medical 
manufacturing firm of Parke, Davis & Company, has lost 
its efficient and most worthy president, and we join in ex- 
pression of the general regret that Mr. Theodore D. Buhl 
is no more. His death occurred April 7th of the present 
year. In his loss the medical profession and business 
world, as well as his family and friends, lose a good man, 
genial, personal associate and forceful factor in business 
and professional circles. 

"Ten and a half years ago Theodore D. Buhl cast in 
his lot with this house. Throughout that period he has 
given us the benefit of his large experience, his sound 
judgment, his great power in the commercial world, his 
granite credit reared on an unwavering honesty. As presi- 
dent of the house he was the perfect type of in- 
tegrity and fidelity to all the stockholders. His 
high sense of duty as a trustee pledged to administer the 
property and guard the interests'of others, was ever uppermost 
in his thoughts. The peculiar responsibilities and hazards 
of our work— our obligations as purveyors to the medical 
profession and to suffering humanity, were to him always a 
solemn appeal. The ultimate triumph of character in busi- 
ness was with him a conviction as deep and strong as in- 
stinct. The remote future and the distant prize concerned 
him more than the present gain. 

The strength which he gave this house and all the 
many enterprises in which he shared, signally exhibits 
what the world should realize especially at this hour — that 
rich men of unflinching honesty and sound judgment are of 
inestimable value to their communities. They are the em- 
ployers of labor, the authors of new industries, the creators 

(263) 



264 



In Memoriam. 



of new values, the pioneers who open up vast avenues of 
opportunity for their followers. As they succeed or fail, 
the comfort, the very bread, of thousands is assured or en- 
dangered. We hear much these days of unscrupulous, pre- 
daceous wealth, but what of the type of Theodore Buhl — 
what of the men who consider the trust of their fellow- 
men the best of their possessions, who have a horror of 
stock-jobbing methods, who never seek unfair advantage, 
who never lend their name to a dubious enterprise. 

As a director Mr. Buhl was the soul of courtesy,' kind- 
ness and deference. As an employer he was considerate, 
thoughtful, mindful of the comfort, interests and claims of 
his employes. To their grievances he gave always a pa- 
tient and attentive ear. He encouraged the manly ex- 
pression of honest opinion, and when it differed from his 
own his effort was to convince and persuade, not to invoke 
his authority or impose his will. 

On behalf of the stockholders, employes and executives 
of Parke, Davis & Company we record this testimony to 
the lasting service rendered us by our lamented President. 
To the members of the bereaved family we offer our warm 
and heartfelt sympathy. May strength be theirs to bear 
their sorrow. May they find much comfort in the memory 
of a life rich in well-doing and in good repute." 



CORRESPONDENCE. 



FEINTING, FAINTING BERTHA. — Following is a cor- 
rected version of the woman known to the police as Fainting 
Bertha: 

We are advised that the newspaper statements con- 
cerning this case are not correct in several important details. 
The essential facts are as follows: Bertha originally came 
from Omaha, Nebraska. When quite young she showed a 
certain moral defect, which made it necessary for her 
people to send her to an institution for feeble-minded, 
where she could be kept under close control. She was 
kept there for sometime but either escaped or was dis- 
charged. Soon afterwards, when she was about eighteen, 
she became acquainted with a man, who, as she claims, 
taught her stealing and also was instrumental in inducing 
her to engage in immoral pursuits. Sometime afterwards 
she was adjudged insane and sent to one of the State 
Institutions in Iowa. She escaped from that Institution, 
also from another institution in the same state, to which 
she was again committed. After that she visited very 
many large cities in the country, but mostly Chicago, 
which she seemed to prefer. She was arrested on several 
occasions and sent to the Joliet prison. From there, because 
of her excitement and immoral conduct, she was declared 
insane and sent to the State Hospital at Kankakee, Illinois. 
She escaped from that institution on two different occasions 
and was later sent to the Illinois Southern Hospital, from 
which she also escaped twice. The first time she was 
captured in the vicinity of the hospital and the second 
time succeeded in getting as far as Peoria, Illinois. At the 
request of the Superintendent of the Asylum for Incurable 

(265) 



266 



Correspondence, 



Insane at Peoria, she was re-committed to that Institution 
and is there at present. 

According to the history, also according to the patient's 
own statement, the girl was always backward in school 
and always had shown a very poor emotional control, 
being practically a creature of impulses. She was diag- 
nosed a case of moral imbecility by Dr. Witte of Iowa. 
Other physicians agreed with his diagnosis. 

As regards the "fainting," which gave her the name 
of "Fainting Bertha," according to the statement of the 
patient herself, she was taught the method by a profes- 
sional thief, but did not practice it so much in the stores, 
but frequently in the open by "fainting" into the arms of 
men carrying heavy gold-chains and apparently generally 
well to do and while they caught her and held her she 
succeeded in obtaining all articles of value and concealing 
them in her dress. Aside from this "fainting" method, 
she is also an expert shoplifter, being very quick in con- 
cealing silk and other valuable articles under her clothing. 

Her escape from the Northern Illinois Hospital for the 
Insane was accomplished in the following manner: 

In going to a regular entertainment she succeeded in 
diverting the attention of a new attendant, who had been 
in the institution only about two days. While talking to 
her and walking with her she appropriated the attendant's 
key. A short time after she entered the hall she became 
decidedly excited and it was necessary to have her taken 
back to the ward. She quieted down as soon as she was 
brought back and apparently went to sleep. When the 
attendants returned to the ward after the entertainment she 
was gone. There was no fainting about this last affair. — 
Hospital Interne. 



SELECTIONS. 



CLINICAL NEUROLOGY. 

NERVOUS PHENOMENA DURING PASSAGE OF CHYME 
THROUGH PYLORUS.— (Nervose Erscheinungen beim Ueber- 
gang des Mageninhaltes in den Darm.) F. A. Kehrer. 
Kehrer urges study of the phenomena that occur in some 
persons as the stomach content is passed along into the 
duodenum. He thinks that regulation of the diet might 
prevent the annoying phenomena. He speaks of three 
phases, the phase of sensation of over- loading of the 
stomach; the digestive phase, during which the stomach 
is quiet, and the phase of expulsion of the stomach 
content. During the phase of expulsion local phenomena 
occur in the stomach, heart and lungs. They consist 
in oppression in the epigastrium, oppression or pain in the 
heart region, especially when lying on the left side, 
palpitation and suffocation. These symptoms are probably 
due to direct mechanico-chemical irritation of the ramifica- 
tions of the vagus, or reflex action from the stomach nerves 
on the nerves of the heart. The oppression causes night- 
mare. Any mechanical interference with the respiration, 
for example, by a blanket covering the face of the sleeper, 
may cause nightmare. Another group of nervous phenomena 
at the beginning of the phase of expulsion consists in 
waking out of the first sleep with bad dreams. Kehrer 
thinks that the changes in the circulation of the brain from 
the flow of blood to the digestive organs, causing compara- 
tive anemia of the brain, are not so important a factor in 
these phenomena as generally supposed. More probable, 
he thinks, is the assumption that some of the chyme 

(267) 



268 



Selections. 



passing into the intestines is absorbed immediately by the 
mucosa of the small intestine, and is passed by way of the 
blood to the brain and there induces the above phenomena 
of irritation. Whether it is the peptones, the fat acids or 
the bile pouring out into the duodenum, or whether with 
morbid digestion abnormal products are generated, or whether 
irritating substances from the food are the cause of the 
disturbances is a question still undecided. — Ex. Jour, A. M. A. 

Kehrer concludes with some precautions as to over- 
loading the stomach, at night with tardily digestible food, 
etc. Much depends in these cases upon the erothesen of 
the nervous system including the brain, for a full meal and 
particular foods that disturb at one time do not do so at 
another in the same person. A full dose, say sixty grains 
of bromide of sodium and two fluid drachms each of ess. 
pepsine and essence pancreates, will, immediately after or 
during the meal, abort these unpleasant symptoms. — Ed. 

THE PATHOGENESIS OF FACIAL HEMIATROPHY.— 
A. Gordon reports a case occurring in a negro male, aged 
forty-two years. He cannot believe in the exclusivism of 
the sympathetic origin of the malady, as his own case 
seems to controvert such a theory. According to some 
observers a primary atrophy of the subcutaneous cellular 
tissue is the essential feature of the condition. Others 
believe that it is of a nervous origin and may follow affec- 
tions of either the sympathetic, trigeminus, or facial nerves. 
The majority of cases reported point to an involvement of 
the inferior sympathetic ganglion. Concomitant pulmonary 
lesions are found at the apex in many of these cases. 
This is accounted for by the relations between this ganglion 
and the pleura at its apex. The author's case presented 
not only a trophic disturbance of the facial muscles, but 
also sensory disturbances over the area covering these 
muscles. That the lower cervical ganglion did not play a 
role in the causation of the disease in this case was evident 
from the fact that there were no pupillary changes nor 
vasomotor disturbances on the affected side. It is possible 
that the sympathetic fibers found in the fifth nerve may 



Selections. 



269 



play a certain role in the disturbance of nutrition of the 
facial muscles, but association of sensory disturbances and 
the neuralgic pain in the same area immediately preceding 
the beginning of atrophy present a strong presumption in 
favor of the trigeminal pathogenesis of. the affection. As 
to the question of facial nerve it cannot be admitted in 
this case, as there was no genuine palsy of the affected 
muscles. The patient had preserved the ability of con- 
tracting: them, but the degree of contraction was, of course, 
smaller by reason of the atrophy. The sensory disturbances 
also were against this view. The author concludes that 
hemiatrophy of the face may be caused by the lower sym- 
pathetic ganglion with its nerve, by the fifth nerve, by the 
Gasserian ganglion, finally by a central lesion. The ten- 
dency of some writers to attribute Romberg's trophoneurosis 
exclusively to the sympathetic nerve fibers is erroneous. — 
New York Medical Journal. 

THE INSANITY OF INEBRIETY.— According to T. D. 
Crothers the term inebriety describes a pathological con- 
dition demanding alcohol for its anesthetic effect and refers 
to some depressed state or psychic condition which con- 
sciously or unconsciously calls for relief which alcohol gives 
with satisfaction. Alcohol is not the cause, but merely a 
symptom. Hence the condition must be one of disease 
and organized degeneration. The author then goes on to 
describe various types of this form of insanity and the 
proper methods which should be followed in controlling it. 
He notes that to all ordinary observation a periodical 
drinker resembles the insane in conduct and reasoning. 
Such persons use spirits to extreme toxic states for a brief 
period, then rigorously abstain for awhile and then relapse. 
This resembles acute mania in the dominance of the drink 
impulse overwhelming the mind and body for a period, 
then subsiding. It also resembles epilepsy in its sudden 
convulsive onset, and inability to reason and control up to 
a certain point. Often the periodical drinker is unconscious 
of the import and meaning of these symptoms. He will 
suffer from insomnia, headaches, great irritability, intense 



270 



Selections. 



nervous anxiety, and dread of loss. He will consult phy- 
sicians, believing he has serious organic diseases, go off on 
vacations, make changes in his surroundings and business 
relations, then all unexpectedly, will drink to great excess, 
when all these symptoms will disappear. In most cases 
there are distinct premonitions of the drink storm in conduct, 
reasoning, and appearance, which the friends recognize, but 
the victim does not. A large class of the periodical drinkers 
seem to have some consciousness of the coming attack, 
and use means to avert it. They often go to hospitals 
and sanatoria, particularly where they have had some 
experience before, appearing in a state of great fear and 
excitement, which quickly disappears. The storm is averted 
for the time being, and such cases are always very hopeful. 
In many persons of this class of periodical drinkers, the 
premonitory symptoms take on the form of reasoning manias. , 
Thus they make elaborate preparations in business affairs, 
providing for their absence during drink attacks. Many of 
these persons are active in social and religious work, but 
a period of unusual fervor is often a precursor of a drink 
storm. Some show great exaltation of mental activity; 
others take on a different personality while drinking. With 
some certain atmospheric and electric conditions bring on 
an attack. In all there is an unstable highly sensitive 
brain and nerve organization with a tendency to exhaustion 
on the slightest occasions. A clinical history shows that 
heredity is a very large factor in this instability and feeble 
pain resistance, it also shows that injuries, irregularities of 
living, defective nutrition, sleep, and excessive strains and 
drains with other causes predispose to a convulsive con- 
dition of nerve energy and depression, for which spirits is 
a grateful narcotic. 

JUVENILE ALBUMINURIA. — Ullmann (Ber. Klin. Noch.) 
examined the urine of 42 school children a number of times 
and found albumin in a third of the cases, although the 
children were all healthy. Only one had passed through 
scarlet fever; 9 had had measles, and one recurring tonsil- 
litis. In 3 instances the parents stated that the children 



Selections. 



271 



had never had an acute infectious disease. On the other 
hand, a considerable proportion of the children free from 
albuminuria had a history of scarlet fever or measles in the 
past. The amount of albumin ranged from traces to 10 
per thousand — this largest proportion being found in the 
urine of a girl in apparently robust health. He remarks 
that this juvenile physiologic albuminuria usually vanishes 
without treatment or persists whatever treatment may be 
instituted. It does not seem to have any effect on the 
general health or life expectancy. — Cum. Med. Lit. J. A. M. A. 



NEUROOPHTHALMY. 



THE TENOTOMOMAN1AC who operates on the eye- 
museles for Morton's Toe, Rheumatoid arthritis, phlebitis, 
choroiditis, for all reflex ocular neuroses, for all diseases, 
for anything you please, is a remarkable product of our 
time and conditions. For snipping a tendon (or the conjuc- 
tiva) he secures several hundred dollars, and for doing it 
on the same patient a score or more times he charges 
several thousand dollars. He operates on every patient 
that enters his office, and no one knows whether the oper- 
ation is on the tendon or upon the conjunctiva only. One 
thing is certain: — a tremendous effect is made upon the 
patient, his friends, and upon pocket-books. Usually one 
operation suffices to scare the eye or the patient into non- 
complaint or silence. If the subsequent result is good it 
comes through the correction of the ametropia by means of 
glasses prescribed soon after the operation. First the fee; 
second, the operation; third, refract; fourth, credit the cure 
to the operation. From a careful physician in a distant 
state I have just received the following letter: 

"Dr. in this town, a specialist in eye diseases, 

a pleasant man personally, but curiously constituted men- 
tally, so far as his fellow practitioner is concerned, has for 
some years made, as people call it, a specialty of the eye- 



272 



Selections. 



muscles, and, when he finds imbalances, which he finds in 

a great many cases, he sends them to Dr. for 

operation. He claims that Dr. is poor and has 

never made over ten thousand a year. He has gone farther 
than that and got another tenotomist into this state as a 
licensed practitioner and that man comes here every summer 

and operates indiscriminately on cases Dr. has 

reserved for him during the winter. This past summer he 
has been here and, as I hear, performed some 70 operations, 
most of them without much benefit. Now what shall be 
done about this charlatanism? How can it be stopped? I 
hear that this man does not pretend -to test the refraction 
at all, UNTIL he has done the operation for the fee. 1 now 
have in my office an instance which passes comprehension 
had 1 not seen it. A woman of 55 had retinitis with 
choroiditis and small retinal hemorrhages resulting in meta- 
morphosia; O. D. light perception only; O. S. H. with Ast. 
He fitted her to lens O. S. getting 0. 7 V.; O. D. did his 
best getting 0. 2, and then claiming that she had exophoria 
he operated on both eyes twice with no benefit to the 
exophoria, nor, of course, improvement to vision of O. D. 
with its hemorrhages and chorioretinitis. Now why on earth 
any decent man would operate on muscles to cure or relieve 
intense photophobia resulting from chorioretinitis, passes 
my ideas of medical honesty. The condition is due to car- 
diac disease or an old traumatism of the skull. This is 
indeed muscle-snipping with a vengeance, is it not?" 

In the same mail 1 receive a letter from a critic who 
urges that the profession must be united against ophthalmic 
quacks outside of the profession. 1 answer that this is a 
most desirable thing, and that 1 have urged it every year, 
in season and out of season, for all the years of my life 
as an oculist. But 1 add the query: What about the 
quacks within the profession, shall they be asked to join 
in the crusade against those outside? Our own little Augean 
Stable is pretty mirey. Do we care less for the mire than 
we do for getting the professional stabling? Good medicine 
as well as cunning astuteness would appear to counsel the 
cleaning of the professional stables. The scientific blunder 



Selections. 



273 



which explains the vogue of the tenotomomaniac is the 
nonrecognition of the truth that heterophoria is primarily 
and almost always the result of uncorrected and malcorrected 
ametropia. Prevent the eyestrain and the heterophoria is 
prevented. Neutralize the eyestrain of ametropia and 
tenotomy is unnecessary. Surgicalizing the effect does not 
cure the cause. The addition of quackery to the surgery 
scarcely lessens the evil-doing. — From Types of Ophthalmic 
Charlatanism, by Geo. W. Gould, Dec. No. Cleveland Med. 
Jour. 



NEUROSEMEIOPATHY. 

ABORTION AS A CAUSE OF TETANUS. — Tetanus and 
other nervous disorders may follow abortion. The follow- 
ing instances are recorded in lately arrived medical 
dictionary : 

"Case of tetanus following abortion at the fourth 
month. Brownlee (New England Med. Monthly, Nov. '91). 

"Case of Hemiplegia following abortion. The cervix 
had been dilated with tampons to remove an adherent 
portion of the placenta. Fenwick (American Jour, of Obst., 
Apr.,'91). 

"Case in which, twelve days after a supposed artificially 
produced abortion, a 30-year-woman suffered from trismus 
and tetanus, the convulsions being severe and frequent. 
Successful treatment by means of antitoxin. Ch. F. Well- 
ington (Boston Med. and Surg. Jour., vol. cxxxiv, 
No. 3, '96). 99 



NEUROTHERAPY. 

FURTHER EXPERIENCE WITH OPSONINS.— Reports are 
now beginning to come in from various observers relative 
to the matter of opsonins and the positive value of the new 
theory. In the Lancet of January 5 is a report of a recent 
meeting of the Manchester Pathological Society, at which 
Professor A. H. White of Dublin related the results of his 
experiences of inoculation on the lines laid down by Wright, 



274 



Selections. 



and explained the necessity of repeated blood examinations 
in order {a) to regulate the size of the dose and thus to 
eliminate the negative phase effect as far as possible; and 
(b) to determine the length of time its effects lasted. He 
detailed the effects of surgical procedure on the opsonic in- 
dex and showed how clinical improvement following a sur- 
gical operation where only a part of the disease was re- 
moved was coincident with a rise of opsonic index, and 
that relapse with involvement of a fresh area resulted 
when a fall in the index occurred. Moreover, he showed 
that such cases might be completely cured by inoculation, 
as soon as the opsonic index fell, of suitable and properly 
interspaced doses of tuberculin. In the course of the dis- 
cussion, Dr. Loveday showed that an attempt to find a 
small dose of tuberculin which could be used empirically in 
all cases failed. Different doses of T. R. had very differ- 
ent actions in the same person. A very small dose might 
give a curve of opsonic indices very similar to that obtained 
by too large a dose. In some cases it was really too large 
and still smaller doses were required, while in others a 
larger dose gave satisfactory results. There was an op- 
timum dose for each patient only to be determined by fre- 
quent observations of the opsonic index. The question was 
still further discussed by Dr. Ramsbolton, who spoke of the 
therapeutic use of inoculations of staphylococcus vaccine in 
certain common affections, and emphasized their value in 
cases of furunculosis and the severer forms of acne, when 
the pustular eruption was plentiful and the individual pus- 
tules were large, in contrast to the milder cases of acne 
consisting of a "few spots on the face" which did not 
seem to yield so readily to this treatment. In quoting the 
actual cases treated stress was laid on the fact that the 
opsonic index, before treatment, in the cases of furunculosis 
and the severer forms of acne, was below normal, whereas 
in the milder forms of the latter affection the index was 
about, or just above, normal. — Ed. Med. Rec, Jan. 26, 1907. 

DIONIN. — In Merck's Archives for October, (from 
Ophthalmic Record), G. C. Savage observes that since 



Selections. 



275 



dionin is neither a mydriatic nor a myotic, it has been 
hard to understand how it can help atropin to dilate the 
pupil in iritis, and also aid eserin in contracting the pupil 
in glaucoma. Recent observations on cases of iritis in 
which there was not only complete adhesion of the pupil- 
lary margin to the lens capsule, but the pupillary opening 
was also filled with plasma, and a solution of dionin was 
used five minutes after the instillation of the atropin, 
showed the plasma disappearing from day to day and at 
the end of one week it had entirely disappeared. The 
pupil dilated slowly, but in all there was practically com- 
plete dilatation. The disappearance of the plasma that 
could be seen was proof that the unseen plasma binding 
the iris to the capsule had also disappeared, — that it had 
been iissolved and carried out of the eye by way of the 
lymph channels. There is no room for doubting that dionin 
did this work. It is reasonable to conclude that dionin helps 
to dilate the pupil in iritis by its solvent effect on the 
plasma that would cause and maintain adhesions, and that 
it hurries out of the eye the the dissolved plasma by open- 
ing the lymph channels. The relief of pain is another very 
desirable effect to the credit of dionin. In the treatment of 
iritis this drug is invaluable when used, of course, in con- 
junction with atropin. How dionin aids eserin in contract- 
ing the pupil in glaucoma and how some contraction might 
be effected by dionin alone, would not seem hard to under- 
stand. By opening the lymph channels, thus encouraging 
the outflow of the watery contents of the globe, it lessens 
intraocular pressure, this allowing a freer flow of nerve 
stimulation to the sphincter muscle of the iris. 

THE TREATMENT OF NOISES IN THE EAR UPON A 
DIET FREE FROM SALT. — Lermoyez records (Ann. d. mal. 
de I'oreille, du larynx, etc., Paris, 1906, November) the case 
of a man, aet, 76, who had suffered for eight months from 
noises in his left ear resembling the crackling of parch- 
ment. They were intermittent in character, but they be- 
came almost unbearable. Sometimes at their onset they 
caused vertigo, so that the patient was obliged to support 



276 



Selections. 



himself. The noises could not be heard by the examiner, 
even with the auscultating tube. There was no evidence 
that either the tensor tympani or stapedius muscle was 
concerned in the production of the tinnitus. The hearing 
was defective, and low tones were rather better perceived 
in the left ear, in which were the noises, than in the 
right, which was free from them. 

The difficulty was in determining the cause of the 
tinnitus, and, under the impression that it arose from extra- 
aural influences, no local treatment was applied, but the 
patient was instructed to modify his diet and improve his 
hygiene. As the result of adopting a salt-free diet, an ex- 
cellent result was obtained: the tinnitus became less 
marked, and finally disappeared. Pierre Bonnier, who some 
years ago studied the influence of Bright's disease upon 
the ear, published an observation, which apparently did not 
receive much attention. In the case of a young girl who 
suffered from spasmodic contractions of the tensor tympani, 
the exhibition of a milk diet caused the total disappearance 
of her ear symptoms. He attributed this tonic contraction 
as due to some degree of renal insufficiency. In Lermoyez's 
case, albumin was found in the urine. He did not put his 
patient upon a purely milk diet, but contented himself with 
eliminating the chlorides. This restriction, as already in- 
dicated, proved most successful. 

This question of diet has already been the subject of 
more than one communication in connection with affections 
of the ear, nose and throat. Thus Jaquet (Ann. d. mal. 
de Voreille, du larynx, etc., Paris, 1904,) drew attention to 
the remarkable effect of a salt-free diet in the treatment of 
chronic obstructive nasal catarrh. It proved of more value 
in patients suffering from Bright's disease than did any 
local treatment. At a more recent date, Chauveau (Arch, 
Internal. Laryngol., Rhinol., u. Otol., 1905,) has been able 
to modify a chronic pharyngitis by similar means, and at- 
tempted to improve the dry form of pharyngitis by increas- 
ing the chlorides in the diet. The whole subject seems 
worthy of further attention. — Edinburgh Medical Journal. 



Selections. 



277 



ALCOHOL IN DIABETES is advocated by American 
Medicine on the ground that there is reason to believe that 
the first step in sugar metabolism by the cells is to con- 
vert it into alcohol. During the period then that the sugar 
and starches are withheld it is believed to be well to de- 
liver alcohol to the cells in minute doses and frequently, 
in order that the body may, by being built up, secure con- 
trol of sugar metabolism. Small doses frequently repeated 
and well diluted appear to give excellent results. — Medical 
Fortnightly. 

DR. HAWKINS, of the Denver Medical Times, makes 
the following interesting observation on Quinine, excepting 
only the commendation of grain doses, which are excessive 
in any but the extremely depressed stages of the pernicious 
forms of plasmodial imprisonment when absorption is slow 
and the entire alimentary tract may be loaded with the 
salt without harm: 

"Quinin is a general protoplasm poison, having a 
destructive predilection for protozoa, particularly the Plas- 
modium of malaria, which is destroyed by this alkaloid in 
as weak a dilution as 1:20,000. It is therefore a specific 
against malaria and is best given in a gram dose four or 
five hours before the expected chill, that is, during the 
ameboid stage of sporulation. Quinin is excreted, mostly 
unchanged, in the urine, appearing here within a half hour, 
and disappearing mainly within 48 hours. Small doses 
(1 to 3 grains) raise blood pressure and strengthen the 
heart beat; large doses (1 or two grams) have an opposite 
effect. The leucocytes are lessened in number, diapedesis 
prevented, red blood cells relatively increased, and urea and 
uric acid diminished. The effects of excessive dosage 
(cinchonism), including tinnitus aurium, deafness, headache, 
epistaxis and blindness, appear to depend chiefly on cere- 
bral congestion and are controllable with bromids. Erythema 
is often noted in idiosyncratic cases. Quinine is contrain- 
dicated in acute diseases of brain and ear. 

"Many members of the laity take quinin as a 'tonic* — 
often with a dash of whisky—whenever they have 'caught 



278 



Selections. 



cold' or are otherwise depressed. The custom is not a bad 
one, providing only small doses (say 2 grains t. i. d.) are 
used for a few days. Laxitives and restricted diet, how- 
ever, are more essential. The treatment of lobar pneumonia 
with large doses of quinine, followed hy Juergensen thirty 
years ago and recently revived by Galbraith and others, is 
but another illustration of the cyclic nature or fads. It 
proves, if nothing else, that the average patient of sound 
constitution and between the extremes of life, will recover 
from pneumonia despite a 'whole lot of dosing.' Quinin is 
serviceable in most conditions of vasomotor instability, 
chills, for example." 

Hawkins conducts one of the best journals of the Rocky 
Mountain region and is so thoroughly accurate in his edi- 
torial statements that we have never before differed from 
him and even in this the difference there is probably in 
sacrificing qualification to terseness of statement. 



HAEMONEUROTHERAPY. 

OPSONIC THERAPY.— Charles D. Aaron, M. D , of De- 
troit, has contributed to the New York Medical Journal a 
valuable account of the work of Sir A. E. Wright, together 
with that of Stewart R. Douglass and J. Freeman, in the 
pathological laboratory of St. Mary's Hospital in raising the 
antibacterial power of the blood over invading microbes. 

According to the revised views which Wright now 
holds, and which came step by step through his use of 
various bacterial substances in the form of vaccines, op- 
sonin is an ingredient of the blood serum which aids 
phagocytosis by its inhibiting action on a given micro- 
organism. That is to say, it acts on the microbe and pre- 
pares it to be ingested by the protective body cells or 
phagocytes, chief among which are the polynuclear leuco- 
cytes of the circulating blood. The blood serum of man 
contains opsonins for various pathogenic bacteria, and in a 
state of health this opsonic content, or "opsonic index" as 
it is called, is at a certain or normal level. By an ingen- 



Selections. 



279 



ious method which Wright and Douglass have devised the 
opsonic index for any particular pathogenic microbe can be 
determined. This method consists essentially in mixing 
with fresh human leucocytes, the serum to be tested, and 
an emulsion of the particular bacterium under investiga- 
tion. After a short incubation this mixture is spread as in 
making a blood film, stained appropriately, and then examined 
with suitable microscopic power. The phagocytic leuco- 
cytes will now be revealed containing the bacteria in their 
substance, and by counting the contained bacteria in a 
sufficient number of leucocytes, striking an average, and 
comparing it with a normal serum, the opsonic index for 
that particular serum and that particular microbe is ob- 
tained. In actual practice the determination of the opsonic 
index can be satisfactorily executed only by a properly 
equipped laboratory expert sufficiently experienced in 
bacteriology and serum pathology, and the same considera- 
tion applies to the production of the various vaccines, and 
further, of course, to such steps as the isolation and identi- 
fication of a given infecting microorganism and the prepara- 
tion of a vaccine from it. 

Now, the opsonic power, or, in other words, the op- 
sonic index fluctuates, rises and falls. During infection by 
a certain bacterial species the opsonic index for this partic- 
ular species is usually below normal, or to use one of 
Wright's phrases, the individual serum is in a "negative 
phase" of opsonic power. Thus in chronic staphyloccus 
disease, as, for example, acne vulgaris, or furunculosis, the 
staphylo-opsonic index is depressed, and in pulmonary 
tuberculosis or osseous tuberculosis or glandular tuber- 
culosis the tuberculo-opsonic index is low. By its natural 
recuperative power, that is, by its spontaneous active im- 
munity, the infected individual may generate opsonins of 
sufficiently increased potency to overcome the invading 
bacteria and to permit the phagocytes to destroy them, 
when natural recovery ensues. Similarly, by hygienic or 
therapeutical measures this opsonic activity of the blood 
serum may be increased. But the chief merit of Wright's 
work lies in the fact that he succeeds, by the use of his 



280 



Selections . 



bacterial vaccines, properly dosed and properly spaced, in 
artificially stimulating the flagging opsonic power of the in- 
fected individual's blood and of arousing it to a point, at 
which healing processes begin and progress to recovery. 
As prepared at the present time these vaccines are sus- 
pensions in sterile normal salt solution of pure cultures of 
various bacteria grown on the surface of agar only to the 
height of vegetative activity, and killed by heating for 
thirty to sixty minutes at 60° C. To guard against sub- 
sequent contamination lysol is added to the finished emulsion. 
Dosage is determined by administering an ascertained 
number of the bacteria, and for counting bacteria in a 
vaccine emulsion Wright has devised a very ingenius 
method. An exception to the vaccines prepared as just 
described is that against tuberculosis, for which Koch's 
new tuberulin in very minute doses is used. 

To illustrate the practical working of Wright's opsonic 
therapy let us take as an example a case of chronic 
stapylococcus infection, say one of long standing furuncu- 
losis, which fails to yield to any of the usual hy- 
gienic or medicinal measures. An examination reveals a 
low opsonic index for stapylococcus, that is to say, the pa- 
tient's serum does not excite a phagocytosis of staphy- 
lococci to the same extent as that of a healthy individual; 
or expressing the condition in other phraseology, the pa- 
tient is in a negative phase of resistance to staphylococci. 
A vaccine is prepared from Staphylococcus aureus, either of 
extraneous origin, or better still, that obtained from the 
victims own furuncles. A subcutaneous injection of about 
200 million of these staphylococci is administered. Now, if 
repeated observations of the opsonic index are made it will 
be found that the immediate consequence of the inoculation 
usually is a further depression of the opsonic index, that 
is, a negative phase ensues. After this brief fall and gen- 
erally within the first three days, the opsonic index rises, 
reaching the normal level and often exceeding it; this is 
Wright's "positive phase" of immunity, and it lasts for 
several days, for longer periods, or even indefinitely, 
though it gradually recedes after attaining a maximum 



Selections. 



281 



point. It is very essential in the event that two or more 
injections of vaccine are required to treat a given case, to 
introduce these additional doses when the opsonic index is 
tending downward, or during the negative phase which 
follows the primary increase of opsonic power. This 
means that the dose of vaccine should only be re- 
peated after the stimulating effects of the previous inocula- 
tion are passing off. Coincidentally with the negative 
phase of the inoculation the patient usually feels indis- 
posed, and the boils may appear aggravated, but with the 
inauguration of the positive phase a feeling of general 
well being and a pionounced improvement of the furuncles 
is noted. Proper doses of correctly prepared vaccines are 
absolutely devoid of danger, and should excite no marked 
local re-action nor disagreeable constitutional disturbance. 

NEUROSURGERY. 

SOME MENTAL SYPMTOMS DUE TO DISEASE OF 
NASAL ACCESSORY SINUSES. — J. A. Stucky, November 
24, 1906, shows by the reports of various cases that acute 
or chronic diseases of the nasal accessorv sinuses often 
gives rise to serious forms of mental disturbance. The 
cases which he has especially observed gave every evidence 
of chronicity. All gave the prominent characteristic 
symptoms of suppuration. All were operated upon after 
the Killian method of entering the frontal sinus, removing 
the floor of the sinus, or enlarging the infundibulum, as 
well as removing the middle turbinate and the anterior 
ethmoid cells, and as many of the posterior cells as could 
be found which gave evidence of suppuration. In these 
cases the ethmoid cells were extensively involved. The 
mental symptoms were very marked. Insomnia, mental 
depression, indifference to conditions or surroundings, 
morbid suspicions, morbid fears and suicidal inclination are 
among the symptoms described. As to their cause, toxin- 
producing bacteria in the gastro- intestinal tract, combined 
with the sepsis from pus absorption, the influence of which 
acts upon the cortical cells and nerve fibers of the brain, 
are probably the chief agents causing the mental disturb- 
ance. — Medical Record. 



REVIEWS, BOOK NOTICES, REPRINTS, ETC. 



THE PROGRAM OF THE FOURTH ANNUAL MEETING OF 
THE PHILIPPINE ISLANDS MEDICAL ASSOCIATION, 
held at Manilla, February 27th, 28th, and March 1st, 
2nd, shows medical interest in organization and progress. 
A Social Meeting and Smoker at the University Club, 
had for Guest of Honor: The Governor General and the 
Members of the Philippine Commission; Major General 
Leonard Wood; The Chief Surgeon, Division of the Philip- 
pines; The Fleet Surgeon, U. S. Asiatic Squadron; The 
Director of Health and Chief Quarantine Officer U. S. 
P. H. & M. H. Service; The Director of the Bureau of 
Science; All Foreign Delegates and Invited Guests and 
The Reverend S. B. Rossiter, D. D. 

The regular membership is about sixty. The papers 
and addresses were: Mosquitoes in the Philippines, their 
Breeding and Habits, with Methods for their Suppression 
(Illustrated); A Picture-talk on Russian Sanitary Ways and 
Means in Manchuria, 1905; Hydrophobia in the Philippine 
Islands; Clinical Observations on Uncinariasis; Necator 
Americanus in Natives of the Philippine Islands; The Phy- 
siologically Active Constituents of Some Philippine Medicinal 
Plants, Arrow Poisons and Fish Poisons; Native Medicinal 
Plants; The Transmission of Leprosy to Apes; The Fate 
of the Agglutinins upon Filtering an Immune Serum; The 
Filtration of Antiserums; Address, Dr. W. V. M. Koch, 
Medical Officer in Charge Infectious Diseases Hospitals* 
Hongkong; Leprosy in the Philippine Islands and the 
Present Methods of Combating the Disease; The Habitual 
Use of Opium as a Factor in the Production of Disease 
Among Chinese; Quantitative Investigations of the Phe- 
nomena of Agglutination (Agglutinin and Agglutinoid) ; 
Observations on the Etiology of Dengue Fever, (a) Appen- 

( 282 ) 



Reviews, Book Notices, Reprints, Etc. 



283 



dicostomy, (b) Additional Report on Result of X-Ray 
Treatment of Hemato- Chyluria due to Filaria Sa^^uinis 
Hominis; Infant Feeding in the Tropics; Address; The 
Recent Trend of Immunity Research; A Summary of Some 
Experimental Work in Plague Immunity and addressed by 
distinguished representatives of Chinese, Japanese, Russian 
and U. S. Army medical interests. The program is well 
executed typographically. 

THE OPEN AIR TREATMENT IN PSYCHIATRY, by William 
Mabon, M. D., New York. Reprinted from the New 
York Medical Journal, for February 9th, 1907. 

This is an interesting, valuable and timely contribution 
to an important matter concerning the welfare of the insane. 
It belongs to the therapy of non-restraint, which, conducted 
by an Alienist of right clinical experience and discriminative 
judgment such as Dr. Mabon, it ought always to be bene- 
ficial to rightly selected patients. 

NEUROGRAPHS, A SERIES OF NEUROLOGICAL STUDIES 
CASES AND NOTES. Editor, William Browning, Ph.B., 
M. D.; Associates, R. M. Elliott, M. D , E. G. Za- 
briskie, M. D., F. C. Eastman, A. B., M. D. and F. 
Tilney, A. B., M. D., Vol. 1, No. 1, March 20, 1907. 
Germany: Th. Stauffer, Universitat-Strasse 26, Leipsic 
Brooklyn- New York, Albert T. Huntington, 1907. 

The copy before us contains: A Case of Brain Abscess; 
Localization; Operation; Recovery, by J. E. Sheppard, 
M. D.; Cephalic Tetanus in America, by F. C. Eastman, 
M. D.; A Case of Myasthenia Gravis Pseudoparalytica with 
Adenoma of the Pituitary Body, by F. Tilney, M. D. ; 
Some Remarks on the Facial Nucleus, by E. G. Zabriskie, 
M. D.; Clinical Studies of the Pressure Effects of Some 
Cardio- Vascular Agents. Part 1. Observations on the 
Hypodermatic Use (Single Injections) of Aconitine; Gel- 
seminine and Water, by F. Tilney, M. D., and R. O. 
Brockway, M. D. ; A Family Form of Progressive Muscular 
Atrophy (Myelogenic Type) Beginning Late in Life, by W. 



284 



Reviews, Book Notices, Reprints, Etc. 



Browning, M. D. ; Note on the Administration of Arsenic 
and An Illustration of Spondylolisthesis. 

THE N. Y. STATE COMMISSION IN LUNACY, for 1905, 
Wm. Mabon, M. D., Prest., makes an interesting and 
valuable showing on the subject with an analysis of 
cases and deductions profitable to Alienists. 
The analysis of cases discussed under headings of 
dementia precox, paranoiac conditions, depressive hallu- 
cinosis, anxiety psychoses, ' mania — depressive insanity, 
psychoesthenic disorders, hysterical psychoses, epileptic 
psychoses, etc., notes of conference of State Superin- 
tendents and Dr. Russell's paper, etc., are good material 
for psychiatric thought. 

W. B. SAUNDERS COMPANY, Philadelphia and London, 
have just issued a revision of their handsome illustrated 
catalogue of medical, surgical and scientific publications. 
This is a most elaborate and useful catalogue. The descrip- 
tions of the books are full, the specimen illustrations are 
accurately representative of the context of books, and the 
mechanical makeup is in keeping with the high order of the 
context. The authors are all men of recognized eminence 
in each branch and specialty of medical science. A copy 
of this catalogue will be sent free on request. 

TEXT-BOOK OF PSYCHIATRY.— A PSYCHOLOGICAL STUDY 
OF INSANITY FOR PRACTITIONERS AND STUDENTS. 
By Dr. E. Mendel, A. O. Professor in the University 
of Berlin. Authorized Translation. Edited and enlarged 
by William C. Krauss, M. D., Buffalo, N. Y. President 
Board of Managers Buffalo State Hospital for Insane; 
Medical Superintendent Providence Retreat for Insane; 
Neurologist to Buffalo General, Erie County, German, 
Emergency Hospitals, etc.; Member of the American Neu- 
rological Association. 311 Pages. Crown Octavo. Extra 
Cloth. $2.00 net. F. A. Davis Company, Publishers, 
1914-16 Cherry Street, Philadelphia, Pa. Knowing the author's 
merit we heartily commend this book. 



Reviews, Book Notices, Reprints, titc. 



285 



PATONS' PSYCHIATRY is a useful and exceedingly valuable 
book to all students of the subject, from a masterful 
source ot right clinical experience. Its author has 
obeyed the injunction of the great Esquirol by living 
with the insane to learn of them in the right clinical way 
and has in consequence produced a book more practical 
than speculative, full of the lessons of experience. The 
author's precepts for the examination of patients are excel- 
lent. Some of them might well have been added to the 
examination of the Thaw case. 

THE SUBCONSCIOUS by Jastrow would likewise help the 
Thaw commission. There are features of the subcon- 
scious life of H. K. Thaw that require critical consideration 
on the part of those whose duty it is now to know of a 
truth the exact state of this man's mind. 

RHYTHMOTHERAPY. — A discussion of the Physiologic Basis 
and a Therapeutic Potency of Mechano-Vital Vibration, 
to which is added a Dictionary of Diseases with Sug- 
gestions as to the Technic or Vibratory Therapeutics. 
By Samuel S. Wallian, A. M., M. D., President Amer- 
ican Medico-Pharmaceutical League. Illustrated. Pp. 
210. Chicago: The Ouellette Press. 1906. 
"This volume attempts to place on a scientific basis 
the much vaunted recent treatment of various ills by vibra- 
tion. It is doubtful whether all can be accomplished which 
is claimed, but exaggeration is to be expected in the 
exploiting of any single method of treatment. No doubt 
vibration has its uses, but they are somewhat sharply 
circumscribed as our increasing experience serves to demon- 
strate. The list of diseases, according to the writer, treat- 
able by means of vibration is long and unreasonable. It 
is, for example, a waste of time to discuss the treatment 
of dementia or of diabetes mellitus or of epilepsy by this 
means." 

We cordially concur in the above estimate of this book 
which we extract from the review department of the Boston 



286 Reviews , Book Notices, keprints, Etc. 



Medical and Surgical Journal. Rhythmotherapy and vibrio - 
therapy have their uses in torpid atrophic states, where a 
course of judicious therapy has preceded and accompanies and 
the possibilities of normal neurotic reconstructive response 
exist in the organism to the form of excitation, yet, unwisely 
or untimely employed the result may be harmful. There 
are cases where the psychic and physical impression may 
be salutary, but seldom as an exclusive method of treatment. 
The wiser and more widely experienced the physician the 
better the possible results. 

WELLCOME'S PHOTOGRAPHIC EXPOSURE RECORD is a 
vest pocket edition of value to photographers in making 
negatives, insuring certainty and uniformity of result. 
The chief features, Exposure Calendar and Calcula- 
tions, Tabloid Developers and Development by the 
time method. Price, cloth 50c. Burroughs, Wellcome 
& Co., New York, N. Y. 

Vaginal Tampons: Some Points of Practical Interest. 
By Charles T. Souther, M. D., Cincinnati. 

American Civic Association. Department of City 
Making. Public Comfort Stations. By Frederick L. 
Ford, Hartford, Conn, 

Ectopic Gestation; with Report of Cases. By O. B. 
Campbell, A. M., M. D., St. Joseph, Mo. 

Some Remarks on Prostatic Hypertrophy. By Charles 
H. Chetwood, M. D., Professor Genito-urinary Surgery, 
New York Polyclinic Medical School and Hospital; Con- 
sulting Surgeon, St. John's Hospital. 

Electricity in the Treatment of Disease. By John 
V. Shoemaker, M. D., LL. D., Philadelphia. 

An Interesting Case of Pernicious Anaemia. By John 
V. Shoemaker, M. D., LL. D., Philadelphia. 

The Scientific Foundation of Modern Treatment of 
Disease. By John V. Shoemaker, M. D., LL. D., Phila- 
delphia. 



Reviews, Book Notices, Reprints, Etc. 287 



The Open Air Treatment in Psychiatry. By William 
Mabon, M. D., New York. 

The Removal of Overhead Wires. By Frederick L. 
Ford, Hartford, Conn. 

Treatment of Croupous Pneumonia in Children. By 
Joseph E. Winters, M. D., New York. 

Some Practical Hints Regarding Medical Postgraduate 
Study in Berlin. By James N. Vander Veer, M. D., Al- 
bany, New York. 

A Case of Heteroplastic Ovarian Grafting, Followed by 
Pregnancy, and the Delivery of a Living Child. By Rob- 
ert T. Morris, M. D., New York. 

Clinical Physiopathology. The Need of a New Classi- 
fication of Diseases of the Nervous System. By L. Harri- 
son Mettler, A. M., M. D. , Chicago. 

Report of Cases of Uterine Fibroids Associated with 
Gallstones. By Albert Vander Veer, M. D., Albany, N. Y. 

Paresis: A Research Contribution to its Bacteriology. 
By F. W. Langdon, M. D., Cincinnati. 

Surgery of the Stomach, with Report of Cases: One 
Case of Gastrostomy. Two Cases of Gastrectomy. By 
Albert Vander Veer, M. D., Albany, N. Y. 

Report of Cases Treated by a Modified Bier-Klapp 
Method of Hyperemia. By James N. Vander Veer, M. D., 
Albanv, New York. 

Sarcoma of the Nose, with a Consideration of the 
Spontaneous Disappearance of Malignant Growths. By 
Robert Levy, M. D., Denver, Col. 

The Cure of Psoriasis, with a Study of 500 Cases of 
the Disease, Observed in Private Practice. By L. Duncan 
Bulkley, A. M., M. D., New York City. 



288 Reviews, Book Notices, Reprints, Etc. 



Surgical Treatment of Tuberculosis of the Upper Air 
Passages and the Ear. By Robert Levy, M. D., Denver, 
Col. 

Prostatectomy in Two Stages; A Conservative Opera- 
tion with Minimum Hazard. By Charles H. Chetwood, M. 
D., of New York. 

In Refutation of Statements made by the Editor of the 
Bulletin of the American Pharmaceutical Association, as 
published in the issue for November, 1906, and republished 
in the Journal of the American Medical Association. 

Solutions Dobell. By Edwin Pynchon, M. D., Chi- 
cago. 

Reciprocity in Medical Licensure. By Regent Albert 
Vander Veer, M. D., Albany, N. Y. 

End Results in Surgery of the Kidney, Based on a 
Study of Ninety Cases, with One Hundred and Twenty- 
three Operations. By Albert Vander Veer, M, D., Al- 
bany, N. Y.. 

Four Cases of Gangrene. By Albert Vander Veer, M. 
D., and Edgar A. Vander Veer, M. D., Albany, N. Y. 

Feeding in the First Year of infancy. By Joseph D. 
Winters, M. D., New York. 

The Teaching of Laryngology and Rhinology in the 
Denver and Gross College of Medicine. By Robert Levy, 
M. D., Denver, Col. 

Symposium on Amebic Dysentery. By John L. 
Jelks, M. D., Memphis, A. A. McClendon, M. D., Marianna, 
Ark., and J. A. Crisler, M. D., Memphis. 

Thirty-third Annual Report of the Medical Director 
of the Cincinnati Sanitarium for the Year ending Novem- 
ber 30th, 1906. 



Reviews, Book Notices, Reprints, Etc. 



289 



Report of the Department of Health of the Isthmian 
Canal Commission for the Month of January, 1907. W. C. 
Gorgas. Colonel, Medical Corps, U. S. Army. Chief San- 
tary Officer. 

Annual Report of the Department of Health of the 
Isthmian Canal Commission for the Year 1906. W. C. 
Gorgas. 




A new book, Diet after Weanii 

We have issued this book in response to a constantly inci 
ing demand for suggestions on the feeding and care of thee 
between the ages of one and two years. 

We believe you will find it a useful book to put in the hi 
of the young mother. 

The book is handsomely printed, fully illustrated an 
bound in cloth. We shall be glad to furnish you copie 
patients entirely free. 

A postal card with your name and address on k will t 
you a copy by return mail. 

MELLIN'S FOOD COMPAN Y BOSTON. M, 



PUBLISHER'S DEPARTMENT. 



WITH OUR MARCH 1907 pamphlet, we commence the 
issue of a series of 18 illustrations of dislocations, the first 
being bilateral dislocation of the jaw. These illustrations will 
complement our illustrations of long bone fractures, and the 
two series will make a valuable collection for the busy 
practitioner. Physicians who are not on our mailing list 
can get them free, by application to Battle & Co., St. Louis. 

THE BEST HYPNOTIC —A patient who would sleep but 
cannot sleep should be made to sleep. In the choice of a 
hypnotic the physician should always seek that one which 
not alone is most effective, but which presents the fewest 
disadvantages in the way of after effects. For years 
Bromidia has been the standard hypnotic prepared at the 
command of the profession. Through all the time that it 
has been known it has never failed in composition or effi- 
ciency. Its constituents have been of the purest, and in 
fact, Bromidia has been the standard by which similar 
preparations have been measured. That the medical pro- 
fession has appreciated its worth and thorough reliability is 
well apparent, from the place it holds in the regard of 
every physician who appreciates stability and honesty. — 
The International Journal of Surgery. 

ALETRIS CORDIAL RIO represents one of our most re- 
liable indigenous agents for uterine ailments. Reports of 
its efficacy in numerous cases of amenorrhea, dysme- 
norrhea and menorrhagia affirm its value in the treatment 
of these cases. 

AN ANNUAL VISITOR.— We have just passed through 
our annual epidemic of la grippe, which as usual, claimed 
its victims among all classes and conditions, mainly, how- 

( 290 ) 



ITS COVER PORTRAITS 

have made it famous 



AGE: TWENTY-FIVE YEARS 

— and still growing! 



7246 



PROGRESSIVE 
PHYSICIANS 



READ THE 
MEDICAL 
HERALD 



OFFICIAL JuURNAL 
MEDICAL SOCIETY 
OF MISSOURI VALLEY 



YOl 



MAY BECOME ONE 
OF THIS CLASS FOR 
ONE DOLLAR . . . 



Clean, Ethical, Newsy, Original. Un- 
trammelled by trade connections — unbiased 
in its utterances — and broad enough to re- 
nounce illogical traditions and narrow 
dogmas . 



Its Original Department reflects 
the progress of the stalwart Prac= 
titioners of the great Middle West. 



The Oldest Independent 
Medical Monthly 
west of the 
Mississippi River 



EDITED AND PUB- 
LISHED BY MEDICAL 
MEN: ITS AIM TO AD- 
VANCE THE CAUSE OF 
SCIENTIFIC MEDICINE 



CIRCULATES 
IN A FIELD 
PECULIARLY 
ITS OWN 



$1.00 the year 



For specimen copy, premium list and schedule for game "500" address 

DR. CHAS. WOOD FASSETT, 

Managing Editor, ST. JOSEPH, MO. 



Publisher's Department . 



291 



ever, among the classes where the resisting power was 
below par, or among sufferers from some chronic ailment. 
While the sequelae and complications of this disease may 
assume almost any phase of accute inflammatory character, 
its primary effect is upon the nervous system. Therefore, 
we have no hesitancy in saying, no matter what the local 
inflammation may require as a medicine, by all means give 
antikamnia tablets as a nerve sedative and to relieve the 
muscular pains always present. We have seen a violent 
cough of bronchitis treated upon the general plan, with the 
cough as distressing at the end of twenty-four hours as at 
the beginning, promptly yield to six antikamnia tablets 
during an interval of six hours. La grippe usually requires 
a double treatment, one directed to the influenza, and the 
other devoted to the complications present, be they of the 
respiratory organs or digestive tract. In all cases anti- 
kamnia tablets will be found to perform a prominent and 
successful part and purpose. — Medical Reprints. 

THE PHYSICIAN who employs Peacock's Bromides can 
depend upon best possible bromide results. This prepara- 
tion never varies in strength, and eminent American and 
English analytical chemists have testified to the extra 
purity of the salts entering its composition. It has long 
been and will continue to be an important consideration to 
neurologists and general practitioners who wish to resort to 
a continued bromide treatment. 

TO GUARD the functions of the heart is characteristic 
of the therapeutic action of Cactina Pillets. This conclu- 
sion reached by Myers more than fifteen years ago has 
been fully sustained by clinical experience. According to 
Myers, its power to increase that musculomotot energy of 
the heart, elevating the arterial tention and increasing the 
height of the pulse wave, makes it a cardiac tonic stimulant 
of importance in the treatment of irregular and feeble heart 
action. 

ADMINISTERED AFTER OPERATION, Fellow's Hypo- 
phosphites exercises a most beneficial influence upon the 



The Ralph 
Sanitarium 

For the Treatment of 

Alcoholism and 
Drug Addictions: 

THE method of treatment 
new and very successful, Tl 
withdrawal of the drug ism 
attended by any suffering, and tt 
cure is complete in a few week 
time. The treatment is varied a 
cording to the requirements i| 
each individual case, and the re J 
toration to normal condition j 
hastened by the use of electricit] 
massage, electric light baths, h i 
and cold tub and shower battj 
vibratory massage, and a liben| 
well-cooked, digestible diet, i 
modern, carefully conducted home sanitarium, with spacious surroundings, and attractive driv 
and walks. Electro- and Hydro-therapeutic advantages are unexcelled. Trained nurses, hot wat 
heat, electric lights. Special rates to physicians. For reprints from Medicaljournals and full deta 
of treatment, address 

DR. B. B. RALPH 529 A^ h u L and Kansas City, Mo 





MARL 





THE MAN 
WHO KNOWJ 

goes after deer and all big game w 
Marlin. He backs his own skill 
Marlin accuracy. 

Marlin Repeaters have original 
tures shown by no other make, 
shoot truer, stand harder service ani 
absolutely dependable. 

The Model 1893 Marlins have 
Smokeless Steel" Barrels using pow 
smokeless loads. The .32-40 and 
sizes are also made with the highest 
of soft steel barrels for black po 
The .30-30, .32-40 and .38-55 rept 
are the guns for deer and similar { 
The Men Who Know have told 
of good Marlin stories in our Expei 
Book — Free — with our catalogue 
best so far) for 3 stamps postage. 

THE MARLIN FIRE ARMS 

42 Willow St., New Haven, I 



Publisher s Department. 



292 



patient's nutrition, fortifying the recuperative powers, and 
thereby hastening convalesence. 

DANGEROUS USE OF CURRANTS.— An English physi- 
cian, James Cantile, speaks in strong terms of condemna- 
tion of the growing custom of using currants in bread and 
cake. The baking, he says, makes them wholly impervious 
to any digestive fluid, wherefore they result in serious in- 
testinal disturbances, especially in children. 

COCA AND THE SALICYLATES —J. H., Cincinnati, O., 
writes to the editor of The Coca Leaf: "Following a sug- 
gestion in The Coca Leaf as to the depurative action of 
Coca, I have used Vin Mariani to assist the elimination of 
uric acid, giving the wine either alone or alternately with 
the salicylates. 1 wish to express my appreciation of this 
remedy, which has opened a field of usefulness to me." 

It is equally pleasant to record as to give kindly sug- 
gestions. Attention directed to the applications of Coca, 
based upon its physiological action, will indicate many uses 
for this remedy which will prove satisfying to both patient 
and physician. 

The indescribably depressing action upon the stomach, 
often complained of by patients who take salicylates, may 
be obviated by using Vin Mariani as a vehicle. Fifteen or 
twenty grains of salicylate of soda in two ounces of Vin 
Mariani affords a palatable and efficient remedy in the 
elimination of uric acid. This dose may be found service- 
able twice daily, after eating, and again at bed time if 
indicated. — The Coca Leaf. 

IMPENDING HYPOCHONDRIAC DEATH BY SUGGES- 
TION. — Modem Eloquence relates the following: An English 
traveler once met a companion sitting in a state of the 
most woeful despair, and apparently near the last agonies, 
by the side of one of the mountain lakes of Switzerland. 
He inquired the cause of his sufferings. "Oh," said the 
latter, "1 was very hot and thirsty and took a large draught 
of the clear water of the lake, and then sat down on this 
stone to consult my guide-book. To my astonishment I 



WE SUPPLIED ALL THE CITY INSTITUTIONS WITH DRY GOODS LAST YEAR. 



WM. BARR GOODS CO. 

Keep the Largest Stock of Goods suitable for 

HOSPITAL PURPOSES 

TO BE FOUND IN ST. LOUIS, 

And Special Terms will be made with all Institutions ordering from them. 

BEDDING MATERIALS OF ALL KINDS, 

UNDERCLOTHING, IN SILK, WOOL AND COTTON, 

LADIES' AND CHILDRENS 1 READY-MADE CLOTHING, 
FLANNELS AND UPHOLSTERY, 

TABLE AND BED ROOM LINENS, 

SOAPS, NOTIONS AND PERFUMERIES, 
ARE ALL SPECIALTIES AT THE) 

WM. BARR oooos GO'S 

NEW BUILDING, 
SIXTH, OLIVE AND LOCUST, « - - ST. LOUIS 

P. S. Write and find out our special terms to Hospitals. 



i 



HALL-BROOKE 

A Licensed Private Hos- 
pital for Mental and 
Nervous Diseases. 

CASES OF ALCOHOLISM 
AND DRUG HABIT. 



DEAUTI FULLY situated on Long 
*^ Island Sound one hour from New 
York. The Grounds consisting of over 
ioo acres laid out in walks and drives 
are inviting and retired. The houses are 
equipped w th every Modern Appli- 
ance for the treatment and comfort of 
their guests. Patients received from 
any location. Terms Moderate. 

DR. D. W. McFARLAN D, 
GREEN'S FARMS, 
CONN. 

Telephone 67-5, Westport. Conn. 



THE NATIONAL MEDICAL EXCHANGE— Physicians', Dentists' 
1 and Druggists' Locations and Property bought, sold 
rented and exchanged. Partnerships arranged 
Assistants and substitutes provided. Business 
strictly confidential. Medical, pharmaceutical and 
scientific books supplied at lowest rates. Send ten 
cents for Monthly Bulletin containing terms, 
locations, ard list of books. All inquiries promptly 
answered. 
Address. 

H. A. MUMAW. M. D. Elkbart, lnd. 
THE NATIONAL 

Surgical and Dental Chair Exchange. 

All kinds of new and second-hand 
Chairs, Bought, Sold and Exchanged. 

fl^SEND FOR CUR BARGAIN LIST^I 

Address with stamp, 

Dr. H. A. MUMAW, Elkhart, lnd. 

LARGE DIVIDENDS 

Are assured stockholders of the SIERRA- 
PACIFIC SMELTING CO., Sonora, Old 
Mexico. 

Easy Payments. Agents Wanted. 
Write for terms. 

Address, 

HENRY MUMAW, Elkhart, lnd. 



Publishers Department . 



293 



found that the water of this lake is very poisonous! Oh, 
I am a gone man — I feel it running all over me. 1 have 
only a few minutes to live! Remember me to — " "Let 
me see the guide-book," said his friend. Turning to the 
passage, he found, "L eau du lac est bien poissoneux."* 
(The water of this lake abounds in fish.) "Is that the 
meaning of it?" "Certainly." The dying man looked up 
with radiant countenance. "What would have become of 
you," said his friend, "if I had not met you?" "1 should 
have died of imperfect knowledge of the French language." 

LONDON BRAIN-FAG— In London the rush and con- 
centration of business life are yearly exacting a heavier 
toll in brain and nerve disease. The admission waiting list 
of the National Hospital for Paralyzed and Epileptics is one 
hundred acute cases. 

Sir Edgar Speyer, a financier, declared at the dinner 
in aid of the hospital that modern life, with its hurry and 
bustle, constitutes a great strain on the nervous system, 
and that there is a consequent increase in diseases of the 
nerves and brain. 

In four days every week from two hundred to three 
hundred persons may be seen sitting in the out-patient 
department of the hospital in Queen Square, Bloomsbury. 
Most of them are suffering from some form of brain ailment 
or of "nerves." There were nearly 50,000 attendances of 
out-patients last year. 

Out of the 1100 who were treated as in-patients, 69 
were doomed to die, while 200 were discharged as either 
cured or as much relieved. 

Who are the persons who make up the army of pa- 
tients? Godfrey Hamilton, secretary of the hospital, says 
they are in a large degree a rather different class from the 
patients to be seen at the Ordinary General Hospital. 
There are clerks, governesses, shop workers and cashiers 
and in the paying wards there are solicitors and doctors. 

"What is wrong is that Londoners nowadays have too 

*Liberally translated: The water of this lake is very fishy or good for 
fishing. 



St. Louis Baptist Hospital, 




DR. C. C. MORRIS, Supt. 

N, E. COR. GARRISON & FRANKLIN AYES,, 
St. Louis, Mo. 



This hospital is open to the medical pro- 
fession generally, and physicians who bring 
their patients here are guaranteed every 
courtesy and the exclusive control of their 
patients. It has a well equipped Bacteriolog- 
ical and Pathological Laboratory under the supervision of a physician well trained in thes< 
branches. Surgical cases are given special attention Address all communications to 




DR. C. C. MORRIS, Supt. 



Impotency Cases 



It matters not how hopeless; cured or relieved by our combination. 

Helantha Compound. 

Helianthus annuus [sunflower.] Fr. root, bark.H. Australian. Plain 
or with diuretic. 

Has a powerful action upon the blood and entire organism is in- 
dicated in aU cases complicated with Malaria, Scrofula, im- 
poverished Blood, Anaemia, etc.. etc., in conjunction with Pil Orient- 
alis (Thomoson), will control the most obstinate cases of Impo- 
tency. "Drink Cure" cases, saturated with Strychnine, "Weak 
Men" cases, who tried all the advertised "cures" for impotency, 
and were poisoned with Phosphorus compounds readily yield to 
this treatment. Pil Orientalis (Thompson) contains the Extract 
Ambrosia Orientalis. 

The Therapeutical value of this Extract as a powerful Nerve 
and Brain tonic, and powerful stimulant of the Repro- 
ductive Organs in both Sexes, cannot be over-esti- 
mated. It is not an irritant to the organs of generation, but A 
recuperator and supporter, and has been known to the native 
Priests of India, Burmah and Ceylon for ages, and has been a harem 
secret in all countries where the Islam has planted the standard of 
Polygamy. 

It is impossible to send free samples to exhibit in Impotency 
cases, requiring several weeks treatment, but we are always willing 
to send complimentary packages of each preparation (with formulas 
and medical testimonials) to physicians who are not acquainted 
with their merits. 

p . { Helantha Compound, $1.85 per oz. Powder or Capsules, 
rnces. \ pj , Orienialis(Thompson)$1.00 per box. 



THE IMMUNE TABLET COMPANY, 



WASHINGTON, 
D. C. 
AGENTS: 

Meyer Bros. Drug Co., St. Louis. 
Lord, Owen & Co., Chicago. 
Hvans-Smith Drug Co., Kansas City. 
Redlngton & Co., San Francisco. 
J. L. Lyons & Co., New Orleans. 



CLAM 



ENGRAVING 
CO. 

MEANS — THAT YOU 
CAN GET HIGH GRADE 
CUTS FOR ANY KIND 
OF LETTER PRESS 

PRINTING AT 

8 4 MASON ST 
M I LWA UKEE 



HALFTONES ON ZINC OR COPPEI 
WOOD ENGRAVING tf^J&tMN 
ORIGINAL DESIGNERS a ARTIST 



Publisher's Department . 



294 



little holiday, and the thing that is needed to counteract 
the tendency to 'nerves' and brain trouble is a universal 
'week-end,' " said a nerve specialist. 

"Twenty years ago the Londoner lived nearer his 
work, and his work was less exacting. He was able to 
get sufficient recreation and rest Saturday afternoon and 
Sunday. 

"But nowadays it is different. All London is engaged 
in a daily rush to and from the suburbs, in motor-omni- 
buses or underground trains, and most people crowd more 
work into less time. There is much more worry and more 
responsibility. The result is seen in brain-fag and nervous 
breakdown." 

NEURASTHENIA. — To-day it is generally recognized that 
neurasthenia is a real morbid condition. It is not the re- 
sult of modern civilization, as many writers would have us 
believe, but an actual disease that has probably existed as 
long as society. The name is not a generic term and 
when so used implies ignorance of the real condition it 
describes. Instead, it represents a specific malady with a 
definite etiology, pathology and symptomatology. There 
can be no question but that the trend of modern life, 
particularly under certain conditions, tends to aggravate 
and multiply cases of this disease. Overwork is unques- 
tionably one of the principal causes, coupled with anxiety, 
worry or persistent excitement. It is a fact that the nerv- 
ous system or the mental economy of any person can 
stand only about so much. When overtaxed the results 
are bound to be disastrous, just as a muscle will suffer 
from excessive work. Add to overwork, individual habits, 
including excesses of all character, and neuropathic ten- 
dencies which are all too often the result of hereditary in- 
fluences, and it can be readily seen that nerve tire is of 
prime importance in the development of neurasthenia. 

Within later years certain toxic states, such as syphilis, 
rheumatism, malaria, or the auto- intoxication of chronic 
constipation, have been recognized as important factors in 
the etiology of the disease. At any rate close study points 



CACTINA 

PILLETS 



A Cardiac Tonic 
Stimulant 



From Careus Grandiflora(Mexicana) 

Each PtHef containing One One- 
Hundredth of a grain of Cactina 

Indicated in functional cardiac 
troubles, such as tachycardia, palpi- 
tation, feebleness j and to sustain the 
heart in chronic and febrile diseases. 
It is not cumulative in its action. 

DOSE™ One to three Pillets 
three or four times a day. 
Put tip in bottles of 100 pillets 

Free sample* to Physiciarrs upon request 



Sultan Drug Co», St, Louis, Mo, 

Pharmaceutical Chemists 



SENG 

mmmmmmmmmmmmmmtmammmmmmmmmmmmmmmammmmmmmm 

A Digestive 
Secernent 

A preparation of Panax (Ginseng} 
which is being successfully em- I 
ployed to stimulate the secretory | 
glands of the alimentary canal. 
Indicated m Indigestion, Malnutri- j 
tion, and all conditions arising from I 
a lack of digestive fluids. 

DOSE One or two teaspoonfuis 
three or more times a day 

PUT UP IN 10 OZ. BOTTLES OKLY 

Free samples to Physicians upon request 



Sultan Drug Co., St. Louis, Mo. 

Pharmaceutical Chemists 



PEACOCK'S 
BROMIDES 



THE BEST FORM 
OF BROMIDES 



Each fluid drachm contains 15 grains 
of the neutral and pure bromides of 
Potassium, Sodium, Ammonium, Cal- 
cium and Lithium. 



In Epilepsy and all cases demanding 
continued bromide treatment, its 
purity, uniformity and definite thera- 
peutic action, insures the maximum 
bromide results with the minimum 
danger of bromism or nausea. 

DOSE One to three teaspoonfuls ac- 
cording to the amount of Bromides 
desired. Put up in 1-2 pound bot- 
tles only. Free samples to the 
profession upon request 



Peacock Chemical Co., St. Louis, Mo. 

Pharmaceutical Chemists. 



CHIONIA 



The Hepatic 
Stimulant 



Prepared from Chionanthus Virginica 
Expressly for Physicians' Prescription* 



Chionia is a gentle but certain stim- 
ulant to the hepatic functions and 
overcomes suppressed biliary secre- 
tions. It is particularly indicated in 
the treatment of Biliousness, Jaun- 
dice, Constipation and all conditions 
caused by hepatic torpor. 

DOSE One to two teaspoon- 
fuls three times a day. Put 
up in 1-2 pound bottles only 

Free sample* to Physicians upon request 



Peacock Chemical Co., St. Louis, Mo. 

Pharmaceutical Chemists. 



Publisher s Department . 



295 



to this important fact, that not one, but several causes 
unite to produce the group of symptoms ascribed to 
neurasthenia. 

The prime object in treating this distressing condition 
is to restore nerve balance. Change of scene, regulation 
of the diet and correction of habits and faulty hygienic 
conditions are desirable features. But something more is 
always needed, and without the administration of some 
efficient tonic the neurasthenic will make little or no sub- 
stantial improvement. The principal desideratum is to 
choose a tonic that goes further than mere temporary 
stimulation, one that will assuredly impart vigor to the 
nervous system, and at the same time assist each weak- 
ened organ in the re-establishment of its functions. Such 
a tonic is Gray's Glycerine Tonic Compound. Clinical ex- 
perience has proven the therapeutic value of this well 
known product and under its administration the various 
conditions incident to neurasthenia are corrected and over- 
come. The nerve balance is restored, the digestive organs 
take up their work, normal elimination is promoted, and 
the various symptoms characteristic of nerve exhaustion are 
dissipated without the slightest evidence of undue stimu- 
lation. 

Gray's Glycerine Tonic Compound moveover has this 
very important advantage, it not only aids worn out, tired 
cells and organs to do their work, but it does more — it 
helps them to help themselves. The results obtained, 
therefore, are permanent, not transitory. 

AN OLD SOUTH CAROLINA DARKY was sent to the 
hospital of St. Xavier in Charleston. One of the gentle, 
black-robed sisters put a thermometer in his mouth to take 
his temperature. Presently, when the doctor made his 
rounds, he said, "Well, Nathan, how do you feel?" "I 
feel right tol'ble, boss." "Have you had any nourish- 
ment?" "Yassir." "What did you have?" "A lady done 
gimme a piece uf glass ter suck, boss." — Lippincotfs. 

"WHAT'S THE MATTER across the way?" asked the 
tailor of a bystander, as the ambulance backed up to the 



River Crest Sanitarium sLTc— 

Astoaia, L. I., New York City. in Lunacy. 

FOR NERVOUS AND MENTAL DISEASES. 

Home-like private retreat. Beautifully located. Easily accessible. 

Detached buildingffor alcoholic and drug habitu 
Hydrotherapy, Electricity, Massage. 
J. JOS. KINDRED, M. D., WM. E. DOLD, M. D., 

President. Physician in Char 



New York office 616 Madison ave., cor. 59th St.; hours, 3 to 4 and by appointme 
Phone, 1470 Plaza. Sanitarium Phone, 36 Astoria. 



The Richard Gundry Home, 

CATONSVILLE, BALTIMORE CO., MD. 

A private Home for the treatment of Mental and Nervous Diseases, Opium and A 
tiolic addictions. For Circulars, Rates, etc., Address, 

DR. RICHARD F. GRUNDY, Catonsville, Md 

References — Dr. Henry M. Hurd, Dr. Wm. Osier, Johns Hopkins Hospital, Baltim 
Md. Dr Thomas A. Ashby, Dr. Francis T. Miles and Dr. Geo. Preston, Baltimore, 
Dr. George H. Rohe, Sykesville, Md. Dr. Charles H. Hughes, St. Louis. 



THE BLUE HILLS SANITARIUM milton 

'MASSACHUSETTS. 

A PRIVATE HOSPITAL AND IDEAL RESORT. 
All classes of patients admitted. Separate department for the victims of 
ALCOHOL, OPIUM, COCAINE AND OTHER DRUG HABITS. 

All desire for liquors or the baneful drugs overcome within three days after cntra fj 
and without hardship or suffering. 

A well-equipped Gymnasium, with competent Instructors and Masseurs, for the administration of pi 
hygienic treatment; also a Ten-plate Static Electrical Machine, with X-Ray, ard all ihe various attachmei| 

J. FRANK PERRY. M. D., Supt. 



THE ALPHA SANITARIUM, 

LAKE FOREST, ILLS. 

Established for the treatment of the Functional Derangements and Mo 
Psychologies that occur during Adolescence. 
For further particulars address 

W. XAVTHR SUDDUTH, M. D., 100 State St., CHICAil 



Publisher's Department. 



296 



door of his rival. "A customer fell in a fit, and they are 
taking him to the hospital," was the reply. "That's 
strange," said the tailor. "1 never knew a customer ot 
get a fit in that establishment before!" — Church Register. 

A MlLFORD, O., PAPER tells us that Henry Sigmore 
was held up by two footpads who hit him with a sandbag 
in the neighborhood of the pump station. 

Nephritis or cystitis probably followed. 

A CHAUFFEUR'S RECOMMENDATIONS. — Studied medi- 
cine and law for three years, good experience, capital 
witness, summoned thirteen times without conviction, seeks 
position with 100- horse power motor-car. — Fliegende Blaetter* 

A SMALL BOY threw a rock and hit Jeremiah Plowden, 
of Cleveland, on the boulevard, which compelled him to 
take to his bed as he probably could not sit down after 
such a blow in such a place. 

VARIATIONS IN BLOOD PRESSURE.— In some condi- 
tions the tension which is above normal is not rarely 
present in moderate degree as an endeavor on the body 
to meet a need. A moderate degree of hypotensin is 
physiologic in some illnesses, and should not be interfered 
with. To whip up the circulation at this time solely be- 
cause the tension is low, forces a wasteful and dangerous 
expenditure of energy. Only when overaction of the heart 
is due to low tension, or when renal or pulmonary stasis 
results from this cause, is interference required. — Thera- 
peutic Gazette. 

COLLIER'S WEEKLY ON SCHOOLS.— The function of 
education varies with the population. The rule of the 
three R's is no longer absolute. Education is compulsory 
throughout the country, but it may mean one thing in a 
New England village and another in a large city congested 
from immigration. The age is one of specialization. Of 
music and drawing many common schools now give enough 
to start any talent that may exist in those directions. The 
high schools which fit girls as well as boys for commerce 



The MILWAUKEE SANITARIU1 

Wauwatosa, Wis. 
FOR NERVOUS AND MENTAL DISEASES 

Wauwatosa is a suburb of Milwaukee on the Chicago, Milwaukee and St. Paul Re 
way, 2% hours from Chicago, 5 minutes' walk from all cars and trains. 

Physician in charge: RICHARD DEWEY, A.M., M.D. 

CHICAGO OFFICE, 34 Washington St., Wednesdays 2 t) 4 P. M., (except in Ji 
and August). 

Telephone connections, Chicago and Milwaukee. 



Greenmont-on-the-Hudson. 

For NERVOUS and MENTAL DISEASED 

RALPH LYMANS PARSONS, M.D. RALPH WAIT PARSONS, MX>. 

City Office, 21 East 44th St., SING SING, P. O. , N- Y. 

Mondays and Fridays, 3:30 to 4:30, p.m. Long Distance Tel. , Hart, 140A, Sing Sing, r> 



CREST VIEW SANITARIUM, 

GREENWICH, CONN. 

A quiet refined home for the treatment of 

Chronic and Nervous Diseases, 

In the midst of beautiful scenery, 28 miles from New Yo 

H. M. HITCHCOCK, M. D. 




EUGENE Given Free ! 

£ to each person interested in 

FIELD'S I 
POEMS* 



subscribing to the Eugene 
Field Monument Souvenir 
Fund. Subscribe any amount 
desired. Subscriptions as low 
as $1.00 will entitle donor to 
bis daintily artistic volume 



, Field Flowers' 

(cloth bound, 8x11), «• 



MM an l.llll t certificate of subscription to 

wm ■ J fund. Book coutains a selee- 

mnx f% mm t tion of Field's best and most 

Be 1 1 1 1 M ♦ representative works and if 

U U |\ 5 ready for delivery. 

* But for the noble contri- 
bution of the world's greatest 
artists this book could not 
have been manufactured for 
less than $7.00. 

The Fund created 
▼ided equally between the family of the late Eugene Field ! 
*nd the Fund for the building of » monument to th« mem- X 
or y of the beloved poet of childhood. Address 
EUGENE FIELD MONUMENT SOUVENIR FUND, | 
UUo at Bcok Stores) 10 4 Clinton St., C hicngo j 



THE Book of the century * 
Handsomely Illus- $ 
t rated by thirty- ♦ 
two of the World's 
Greatest Artists. 



i for * 
Is di- ♦ 



WAS ESTABLISHED IN 1886. 



Do Not Be Deceived By Imitators. 

See that the name R. L. POLK A C< 

IS ON THE ORDER BEFORE YOU 
SIGN IT. 

POLK'S is the only complete Medical Director; 
POLK'S is the only Medical Directory having i 

index to all physicians in the United States. 
POLK'S has stood the crucial test of time wi 

increasing popularity. It thoroughly cove 

the field. 



R. L. POLK & CO., Publisher 



DETROIT. 



MICMICA 



SUBSCRIBE SOW. 



This is the Best Medium 
for 

— Sanitaria— 



Publisher s Department . 



297 



increase in numbers every year. Normal schools prepare 
our teachers. In some cities the child may be carried, on 
the taxpayers' money, from the kindergarten through a 
college course. Lately we have gone a step further, and, 
not satisfied with elaborate opportunities for the sound, 
average or normal child, have been developing training for 
those who come maimed into this world — crippled in body 
or handicapped in faculty. The crippled, the blind, the 
dumb have been excluded from the public schools, but the 
less definitely helpless, but still defective children, have 
been allowed to clog the wheels of progress. 

THE JAMESTOWN EXPOSITION. (By Charles w. 
Kohlsaat, Commissioner General.) — Norfolk, Va. — To com- 
memorate the most important event in our Nation's exis- 
tence, there is to be held in the coming year a great Inter- 
national Naval, Marine and Military Celebration on Hamp- 
ton Roads, Virginia, and contemporaneously therewith and 
in close accord, a great historical, educational and industrial 
Exposition, beginning April 26th — the anniversary of the 
day the intrepid voyagers first put foot on American soil — 
and ending November 30th. Our President, Theodore 
Roosevelt thus speaks of it in his proclamation: "Com- 
memorating in a fitting and appropriate manner, the birth 
of the American nation, the first permanent settlement of 
English speaking people on the American continent, made 
at Jamestown, Virginia, on the 13th day of May, 1607; 
and in order that the great events of American history 
which have resulted therefrom may be accentuated to the 
present and future generations of American citizens." 

Let us for a moment go back three hundred years, to 
December 19th, 1606, the day when a little band of in- 
trepid pioneers sailed away from the precincts of London 
(Blackwall, on the Thames) bound for an unknown land, 
there ,to fight fever, famine, and treacherous foes, in en- 
deavoring to establish a foothold in the land of promise, 
endeavors which have been fulfilled beyond the dream of 
prophet. 

That a great and powerful nation should have sprung 



Publisher's Depa rim ent 



299 



from the little settlement made by these pioneers in 1607, 
on the banks of the James River, in the State named in 
honor of the Virgin Queen of England, would seem a fancy 
of a disordered brain, did not fact assure it. 

The genesis of all the older nations are shrouded in 
obscurity, adorned with fable. The great American Republic 
traces its beginning to a definite spot where events hap- 
pened and deeds were done, as thrilling and impressive as 
any that mark the pages of poesy or mythology. 

It was Jamestown that blazed the way for all the 
blessings we now enjoy in our great and glorious country, 
and 1 may even venture to go so far as to say, that but 
for Jamestown being permanently settled, we would not be 
able to give thanks annually to the Almighty for all bless- 
ing bestowed upon our Nation, it is true, the Thanks- 
giving custom dates from the landing of the Pilgrims, but 
had Jamestown failed, had that handful of brave men 
deserted that settlement, perchance the expedition which 
landed many years later on Pilgrim Rock, would never have 
embarked. Who knows? 

To digress for a moment, let me speak of woman. It 
is eminently proper that women play a prominent part in 
the great celebration since it commemorates an event made 
possible by a woman's act three centuries ago, for, had 
not the Indian princess, Pocahontas, saved the life of 
Captain John Smith, the dauntless leader of the first 
English colony in America, when condemned to death by 
his captors, the settlement of Jamestown Island would, un- 
questionably, have been abandoned, the despondent and 
demoralized pioneers returning to England, the new world 
would have been left to the Indians and the early Spanish 
settlers. Woman's work saved Jamestown, and women's 
work is to play an important part in celebrating the three 
hundredth anniversary of the Jamestown settlement, the 
real beginning of the United States. And again, it is to 
women we owe it, that the celebration and the great ex- 
position are to assume such gigantic proportions. To them, 
and more particularly to the Virginia Women's Society for 
the Preservation of Antiquities, who petitioned Congress. 



300 



Publisher's Department. 




Publisher's Department. 



301 



to preserve Jamestown Island and its historic ruins — is due 
the credit for inaugurating the movement from which has 
-sprung the forthcoming celebration and exposition. Hence 
all gratitude and homage to our noble women, especially 
in this instance, to the daughters of Old Virginia. 

Quoting from a late address in Congress, by an elo- 
quent orator, Hon. Charles A. Towne, "No more momentous 
circumstance has ever been celebrated in this (our) country 
than that which is the subject of the proposed observance. 
It would be difficult to over-estimate the significance of the 
event which it is proposed to celebrate. It is one of the 
events that has a consecrated place of imperishable glory. 
In a reverend spirit we shall turn our steps in the May 
time of another year towards the little island in the James 
River, peopled not only by memories, but dedicated forever 
to the respect and homag-e of mankind, by its associations 
with the advent upon the continent of those heroic souls, 
who, three hundred years ago, braved the perils of the sea 
to raise their altars in a wilderness — "and be a fair be- 
ginning of a time." 

Let us therefore, when the spring shall come again, 
gather in Old Virginia about the earliest altar erected to 
our civic worship in this brave new world, and there, 
Americans all, take upon our lips again the holy natal 
vows of our peculiar nationality, strong in the hope and 
resolute in the purpose that in the words of John Adams 
to Thomas Jefferson, "Our pure, virtuous, public-spirited, 
federative republic shall last forever, govern the globe, and 
introduce the perfection of man." 

Let me say in Virginia's name, that in all that Vir- 
ginia has of heritage and tradition, of ideals and aspira- 
tions, the country and all the world has full share, for neither 
a place nor a people can hold alone those things which are 
eternal, and when Virginia opens her gates to welcome the 
world she will open as well her heart and share her best 
with all who come to do her reverance. 



THE 

Alienist and Neurologist. 



VOL. XXVIII. ST. LOUIS, AUGUST, 1907. No. 3. 



PERIODICAL PARANOIA AND THE ORIGIN OF 
PARANOIAC DELUSIONS.* 



By DR. GIERLICH, 

of Weisbaden. 
[Translated bv Smith Ely Jelliffe, M. D., Ph. D.] 

PARANOIA undoubtedly is one of the most pressing 
problems of psychiatrical investigation. The views 
formerly held must be tested and modified in various di- 
rections, both as regards the causative factors which permit 
the occurrence of primary delusions under full consciousness 
and in the absence of melancholy and maniacal moods; 
secondly from the viewpoint of the course and prognosis of 
the disease. 

As regards the etiology, there are two rather divergent 
views. For a long time, Westphal's view [prevailed and 
remained uncontradicted, after he had expressed himself in 
1876. (Naturforscher-Versammulung in Magdeburg) to the 
effect that paranoia is caused by abnormal processes in 
the sphere of conception (ideation), whereas the moods and 
emotions are merely dependent upon the contents of these 
conceptions, without playing a part in tne evolution of the 
pathological psychic phenomena. When the paranoia prob- 
lem was brought *up by Cramer, in 1894, in the Berlin 
Psychiatric Society, strictly in accordance with Westphal, 



*Archiv fur Psychiatric 40. 1905. 

( 303 ) 



304 



Dr. Gierlich. 



paranoia being- contrasted as a purely intellectual psychosis 
with the emotional form — dissenting voices were raised in 
the discussion (Moeli), which ascribed to the emotions a 
contributing influence for the origin of paranoia. At a 
later date, Neisser refers to the significance of the effect of 
emotions upon the relations to the ego. Friedmann attri- 
butes a special part, though not the decisive one, to the 
emotions as concerned in the origin of delusions. Wer- 
nicke describes the influence of emotion upon the formation 
of exaggerated ideas, Hitzig points out the fact that the ex- 
traordinary influence of the emotions upon the development 
of relations towards indifferent occurrences in the surround- 
ings is a matter of every-day experience. Tiling and 
Storring likewise advocate the importance of the emotions 
in the early stage of delusion. Quite recently, Specht, 
Bresler, and still more convincingly, Margulies, based upon 
extensive experience, endeavored to prove that in paranoia 
the emotional sphere is primarily affected, the characteristic 
picture of the disease developing upon this foundation ex- 
clusively. These views were criticized and not accepted by 
Bleuler and Berze. 

Simultaneously with these investigations as to the 
causative factor of paranoia, the time-honored teachings of 
the gloomy outcome, — gradually passing from paranoiac 
delusions to delusions of grandeur, and terminating in 
dementia, — were seriously shaken. Friedmann, for instance, 
described a number of cases with mild, brief delusions end- 
ing in recovery, although the insight and appreciation of the 
disease was not absolute in all cases. Margulies also reports 
three cases of paranoia terminating in recovery, in which 
full appreciation was well maintained in the course of fur- 
ther observation. 

A series of authors, such as Mendel, Meschede, Gia- 
nelli, Kausch. Bechterew, Zeinen, Hamilton — observed cases 
of periodical paranoia with absolutely free intervals and 
perfect appreciation of the disease. It has been pointed 
out by Friedmann that the milder cases do not as a rule 
enter the institutions for the insane. Hence their true 
character is frequently not recognized, they are misin- 



The Origin of Paranoiac Delusions. 



305 



terpreted and therefore appear much less numerous than 
they actually are. Precisely these cases, in which the ob- 
servation of the initial symptoms also is especially favor- 
able under certain conditions, are the ones permitting- a 
thorough study of the pending questions as to the prog- 
nosis and etiology of systematized delusions. 

The author is in possession of three case histories be- 
longing under this heading. The patients have been for 
several years under his observation, and he has been en- 
abled to observe at least two attacks and two entirely 
free intervals, with perfect accuracy, in each individual 
case. 

CASE I. JOURNAL NO. 12. Anamnesis and Status, 
January 24th, 1896. Mr. X., high government official, mar- 
ried for 19 years. Two children, 17 and 14 years of age. 
Wife healthy, no abortions. Patient is descended from a 
nervous family, the mother and, especially the father, are 
said to have been markedly neurasthenic. Mother died 
from some acute internal affection, father supposedly from 
some spinal disease. Two cases of mental disturbance in 
father's family. Particulars not known. 

Patient's birth said to have been normal. He 
graduated from the Gymnasium and chose a government 
career. Study did not come easy, mathematics proving es- 
pecially troublesome, but he was unusually ambitious from 
childhood. Said to have led the simple life, very little re- 
sistance towards alcohol; moderate also in smoking. Ca- 
reer took customary course, only on one occasion the pa- 
tient was not advanced, much to his regret, about a year 
ago. He always had periods of lassitude lasting for days, 
especially after prolonged work; was excitable, complained 
much of constipation, but did not present any other seri- 
ous disturbance of his general condition. After his return 
from a month's fatiguing trip, connected with irregular 
hours and poor quarters, patient complained of insomnia, 
fatigue, heaviness in the head, anorexia, sluggish digestion, 
arrested for 2-3 days, nervousness, irritability, con- 
stant restlessness. Meanwhile, he was able to attend to 
his business, though at the expense of all his will- 



306 



Dr. Gierlich. 



power. He recently showed a suddenly developing mistrust 
towards his surroundings, but without a visible anomaly of 
disposition, and his behavior was perfectly correct. About 
two weeks ago, he expressed for the first time some de- 
lusions, in speaking to his wife: He thought he was no 
longer persona grata, and that he was to be supplanted in 
his position, whereas the exact contrary was true. More- 
over, he thought he had compromised the wife of a col- 
league, namely, the one who had been advanced in prefer- 
ence to him; by gazing at her for a long time, though un- 
intentionally, at some social gathering; this had attracted 
attention, and the woman was compromised by him, who 
had rendered himself impossible. The husband of this 
lady, gradually becoming surrounded by an actual plot, was 
anxious to drive him away from his post and out of the 
town, in order to destroy him. The patient called upon 
the lady to beg her pardon. Of course she had no idea 
what he wanted. He thereupon handed in his resignation 
on two occasions, which was twice graciously refused by 
the president. Finally, he explained to his wife that he 
could not continue to live with her, because she also had 
been compromised by him. It was his duty to give her 
satisfaction by instituting divorce proceedings. 

Status: Patient is entirely dominated by his delusions, 
which he expresses with great animation, in the form previ- 
ously stated. Said he must leave the country, the police 
were liable to come at any moment in order to arrest him. 
A perfect army of opponents was working against him, 
his wife also had joined the plot. Meanwhile, the patient 
was well informed as to the time, place, surroundings, etc. 
Pathological euphoria or depression and psychomotor inhib- 
ition had never been noted, neither did they exist at this 
time. The only anomaly besides well-marked mistrust was 
great irascibility. This was directly parallel to the delus- 
ions, and entirely dependent upon them. There was no 
sign of hallucinations and illusions, which were not ob- 
served in the entire course of the disease. 

Physical examination: Large man, with strong, osseous 
system, much emaciated; said to have lost 15 pounds in 



The Origin of Paranoiac Delusions. 



307 



last few months. Facial features, left half of face bette J 
: developed than right, especially frontal eminence. No ab- 
normality in skull. High pointed palate, small ears, sug- 
gestion of "handle" ear. Tendon reflexes in arms and 
legs lively, skin reflexes normal, sensation and motion, no 
disturbance. Pupils equal, somewhat below medium width, 
react to light, convergence and accommodation. Fundus 
normal, internal organs, negative findings. No albumen, 
no sugar in the urine, no phosphaturia, no uric acid dia- 
thesis. 

The condition remained for nine more days at this 
level. Patient had absolutely no insight into his delusions. 
No hallucinations and illusions could be determined, not- 
withstanding accurate investigation and observation in this 
direction. Then the entire threatening condition rather 
suddenly subsided. Patient could be talked to concerning 
one or the other of his delusions, at least he began to 
discuss them, his irascibility diminished, and after 3-4 days 
more, he showed perfect insight into his condition, together 
with the arrival of an amiable letter from the president. 
Patient fully appreciates the delusionary character of his 
ideas and remembers all details. No amnesia. Does not 
know how these delusions came to him. No indications of 
hallucinations or illusions at time of attack. The body 
weight had already begun to rise and soon reached normal; 
the general condition visibly improved; patient resumed his 
professional activity at the end of a few weeks, and 
everything remained well until the atumn of 1896. 

After, his return from the customary fatiguing business 
trip, the general nervous disturbances reappeared in shape 
of lassitude, headache, insomnia, anorexia, constipation, rest- 
lessness, irritability. By the end of November, the patient 
again developed the same delusions as in the previous 
year, without any maniacal or melancholy fore-runners. 
The attack promptly rose to the former level. The plot 
was again under way, under the guidance of the lady's 
husband. He was to be ousted from his position and 
ruined. Again he handed in his resignation in order to get 
rid of his persecutors, which again was not accepted. 



308 



Dr. Gierlich. 



Claimed he could not continue to live with his wife, he 
had compromised her too seriously — started divorce pro- 
ceedings. Again, a marked loss of weight. Prompt re- 
moval from his surroundings had such a favorable in- 
fluence upon the attack that the condition cleared up rather 
suddenly within 3-4 days, after the persecutory ideas had 
existed during four weeks. The patient gained complete 
insight into the system of his delusions, without the 
slightest amnesia, and without being able to understand at 
all how these two ideas had come about. It proved perma- 
nently impossible to determine hallucinations and illusions. 
Patient soon attended to his obligations as before. 

In the summer of 1897, he had a substitute for his 
professional trip and in the fall took a long vacation, 
which he spent in the mountains. No nervous restlessness 
and delusions were noted. He returned about Christmas, 
feeling so well that he could not be prevailed upon to give 
up a very fatiguing business trip in the summer of 1898. 
Thus the delusions returned precisely as in the preceding 
years, after initial general nervous disturbances in the fal 
of 1898. As before, he remained very self-absorbed for 
some time, and then suddedly aired his delusions. The 
plot with the husband of the compromised lady at its head, 
was again in full sway, in order to ruin him and rob him 
of his position and his honor. 

His resignation was once again handed in, and the di- 
vorce prepared for, etc., etc. Prompt removal from his 
home, and appropriate management, caused the delusions to 
subside about three weeks later, and after 3-4 days more, 
the patient had complete insight into his condition. There 
was no amnesia, and absolutely nothing to point to hallu- 
cinations and interpretations based on illusions. Neither is 
there any reason for assuming discrimination on the pa- 
tient's part in the free interval. At those times, he would 
meet the wife of his colleague without any embarrassment, 
and stated that he felt quite unconcerned towards this 
lady. 

In the summer of 1899, the patient was physically dis- 
abled, but no paranoiac delusions were noted. He died in 



The Origin of Paranoiac Delusions. 



309 



1900 of carcinoma, probably originating from the bladder. 
The somatic status of the nerves remained unaltered. Pu- 
pils, reflexes, sensation and motion presented no disturb- 
ances. There never was a reactionary hyperthemia. He 
was free from pathological fluctuations of the psychic 
sphere. His intelligence had not diminished to a notable 
extent; on the contrary, the patient always promptly met 
the requirements of his position. 

CASE II. JOURNAL NO 36. Anamnesis and Status, 
April 17th, 1896. Mr. X. Aet. 35 years, merchant, mar- 
ried since two years, no children, wife healthy, no history 
of abortion. Patient is descended from neurotic stock, 
father was under author's treatment, for chronic constitu- 
tional moodiness with compulsory ideas. Father's condition 
said to have been even worse in early time of married life 
when there was a severe struggle for business existence 
(about the time the patient was conceived). Two brothers 
of father markedly nervous, one of "peculiar" disposition. 
A younger sister of the patient is said to be hysterical. 
His birth was apparently normal. Patient went to school 
until he passed his final examinations, then took a part in 
his father's business. Studied with tolerable facility, once 
was not promoted to higher class. States that everything 
connected with memory work, such as languages and 
history, came rather easy, whereas thought in abstract 
conceptions was very hard for him. He learned certain 
theses by heart, in a mechanical manner. Was not 
draughted as a soldier, ostensibly on account of a tendency 
to flatfoot. 

Patient at an early age gave an impression of inde- 
pendence, showed great ambition. Was hasty and hurried 
in all his undertakings. Presented no psychical anomalies, 
especially no anomalies of temper. Never lived a fast life, 
had small resistance against alcohol, smoked 2-3 cigars 
daily. Moderate intercourse with girls. When he was 26 
years old his father made him the manager of a large sawmill, 
which had been seriously neglected by poor administration. 
Patient started his new activity with extreme zeal, raising 
the business to a flourishing and remunerative investment 



310 



Dr. Gierlich. 



Showed considerable mercantile skill, was always sober, 
and is much esteemed in his native town. Married at the 
age of 33, from pure mutual affection. Wife brought him 
no money. Marriage was perfectly happy, wife of a gentle 
yielding disposition and uniformly cheerful temperament. 
This harmony was recently very seriously disturbed without 
external cause. In the early part of each year the patient 
is obliged to buy forests on a large scale, for the lumber, 
the year's business essentially depending upon the profit 
of these investments. Patient at this time is much on the 
road, eats irregularly, and has insufficient rest at night. 
Complained much of headache, anorexia, constipation, was 
very irascible and irritable, hurried and restless. He did 
not act toward his wife with the customary frankness, was 
reserved, quiet and self-absorbed. Ten days ago he 
abruptly overwhelmed his wife with the most violent 
delusions of jealousy and persecution. She neglected him, 
doing everything wrong, intentionally and knowingly, she 
was in league with other men, preferring everybody to 
him, she was tired of him, wanted to put him aside by 
killing him, cared only for his money, for which alone she 
had married him. Corresponding to his delusions, patient 
acts most insultingly towards his wife, whom he over- 
whelms with reproaches, saying that she never cared for 
him, married him only for his money, etc. All begging 
and imploring on her part proved useless. Patient is 
extremely irascible, contradiction especially irritating him 
to the last degree. He shrugs his shoulders and expecto- 
rates in front of his wife, unmindful of the presence of 
strange ladies and gentlemen. Once he became aggressive, 
so that the wife lives in constant anxiety and was several 
times obliged to escape by night to her relations. Patient 
takes his meals outside, when eating at home he forces 
his wife to taste of everything before his eyes. 

Status: Patient is entirely dominated by his jealous 
delusions about his wife, inaccessible to reasoning, ex- 
presses his ideas volubly and is extremely irritable. When 
his wife tried to convince him he roughly repelled her and 
spat upon her dress. Meanwhile, he is perfectly conscious 



The Origin of Paranoiac Delusions. 



311 



of place, time, persons, surroundings, etc. Aside from his 
delusions, his behavior is entirely normal. Nothing can be 
discovered and observed in the line of hallucinations or 
illusionary interpretations. A change of disposition to 
abnormal cheerfulness or sadness does not exist, and was 
never noted. Alcoholism is excluded. Physically, patient 
appears as a medium-sized man, with delicate bony frame- 
work and narrow chest. Thorax unusually long, no pigeon 
breast, short receding forehead, remarkable development 
and projection of occipital protuberance, sutures plainly 
palpable. Dolicocephalic. Ears large and projecting, flabby 
without disproportion. Face evenly innervated on both 
sides during rest, when in mimic motion strikingly more so 
on left than on right. Slight degree of blepharocloria, 
pupils equal, medium width, prompt reaction to light, con- 
vergence, accommodation. No nystagmus, hippus, or eye- 
muscle disturbance. Ocuclar fundus normal. Tendon re- 
flexes in arms and legs lively, no ankle clonus, skin re- 
flexes normal. Sensation, motion O. K. No speech disturb- 
ance, no marked tremor, heart normal, pulse 78, evenly 
full and soft. No albumen or sugar irt urine. Internal 
organs negative findings; on both sides moderate flatfoot. 

This condition remained at this level for eight days 
longer, after which time the patient became more quiet in 
the expression of his delusions. At least he entered into 
discussions concerning them, and ceased to act as absolutely 
non-committal and irresponsive as heretofore. In about 
three to four days complete insight into his condition 
manifested itself. He now appreciates the delusionary 
character of his ideas, is dreadfully ashamed of his con- 
duct, does not know what pushed him to these ideas, and 
tries with all his power to undo his wrong towards his 
wife. In this case also, there had been a reduction of the 
body weight (10 pounds) during the attack, which was 
soon recovered from. Patient has no amnesia, on the 
contrary is perfectly familiar with every detail during the 
attack. Nothing to be made out in regard to hallucinations 
and illusions. There were no reactionary changes of his 
frame of mind, his mood was perfectly normal, according 



312 



Dr. Gierlich. 



to the conditions present, neither euphorious nor depressed. 
The irascibility subsided together with the delusions. 
Intellectual deficiency was excluded. He soon felt entirely 
well. 

Suggestions of the above condition are said to have 
returned in the fall of 1896, but were aborted by a journey 
to the South, which had been previously arranged for. 
Patient believed himself safe after this recreation, became 
active in political" affairs and towards the early spring of 
1897 again visited the lumber auction sales. The general 
nervous complaints promptly returned. Nervous lassitude, 
pressure in head, heaviness, anorexia, torpid digestion, 
restlessness, irritability. Patient soon became permanently 
ill-humored, and again showed a change in his manner 
towards his wife. Before she succeeded in getting him away 
from his business, the former jealous delusions returned 
with their old violence. The author found the patient 
entirely beset with his former delusions. He overwhelmed 
his wife with the most horrible reproaches, accused her of 
adultery, of purposeful neglect, said she had only married 
him for a home, she wanted to kill him, was after his 
money only. These ideas he uttered in an animated 
manner, was absolutely inaccessible to reasoniug, became 
much excited when this was tried, cast contemptuous 
glances and gestures at his wife, spat out in front of her, 
and again became actively aggressive. There was no 
pathological mood aside from irascibility and excitement in 
the sense of his delusions, nor was there any acceleration 
or inhibition as regards the course of psychic functions. 
Patient is neither particularly hilarious nor depressed. 

The attack was abridged by the use of baths and 
sulphonal, when necessary. Two weeks after the first 
expression of his delusions patient already showed a 
certain willingness to accept reasoning with him. In two 
or three days more he had perfect insight, without any 
amnesia or reactionary change. He soon devoted himself 
to his business with the same old energy. A son was 
born in December, 1897, to the great satisfaction of the 
father. The wife asked for a long trip early in 1898, for 



The Origin of Paranoiac Delusions. 



313 



she had always held the fatiguing lumber investments in 
the spring responsible for the nervous prostration and 
jealous delusions. The pleasure trip was carried out, and 
nothing turned up in the line of severe nervous disturb- 
ances and jealous delusions. At his return the patient 
found very unsatisfactory lumber investments. In the fall 
the wife worried for some time about the changed manner 
of her husband, but he developed no attack. However, 
another severe attack occurred in 1899. Again, as before, 
general nervous disturbances appeared as above, after the 
lumber investments, followed by changes in his manner and 
delusions of jealousy. The author saw the patient entirely 
taken up by his delusions, as in his previous attacks, 
without any insight. This time he believed a business 
acquaintance of his to be leagued with his wife against 
him, and he abruptly and without cause, broke off valuable 
business connections, much to his later regret. This attack 
lasted about twelve days. The patient then gained com- 
plete insight within two or three days, precisely as in the 
former a!tacks. He resumed his business to its entire 
extent. In the spring of 1900 he took very good care of 
himself. The lumber investments had been entrusted to 
others, and according to the wife's statements, there were 
only certain suggessions of the above-described condition. 
The outbreak was prevented by a short journey. In the 
fall of 1900 he was overjoyed by the birth of a daughter. 
In 1901 he believed himself to have entirely recovered, and 
returned with his old zeal to the lumber auction-sales. 
Again the introductory general nervous disturbances were 
followed without a recognizable external cause, by the out- 
break of his delusion. Patient again was entirely under 
the dominion of his delusions. Said his wife was bad, 
she treated him abominably, tried to deceive him, and to 
get rid of him. He scolded his wife in most vulgar terms. 
Again his business friends were leagued with her against 
him, he broke off another business connection in an insult- 
ing letter to a business company who happened to send in 
an offer at this time. Duration of attack, about twelve 
days, then gradual giving in, quieter behavior, and about 



314 



Dr. Gierlich. 



three days later insight into his condition, to a complete 
extent. In the summer of 1902, patient was seen by the 
author, looking perfectly well and prosperous. A suggestion 
of the terrible condition had manifested itself in the spring 
of that year, but they promptly took a journey to see their 
parents, thus aborting the attack. 

To repeat briefly: Hallucinations and illusions must 
be positively excluded. Dissimulation cannot be assumed. 
What reason would there be for the patient's dissimulating 
in the free interval? On the other hand, he was perfectly 
familiar with all details. This psychic alteration has 
nothing- in common with maniacal or depressive states. The 
delusions are the primary feature, and the emotion is 
dependent upon the delusions alone. Great irascibility 
prevailed during the attack, there was no somatic disturb- 
ance, pupillary reflexes, etc., O. K. The intellect was 
not impaired. Patient managed his extensive business 
affairs with ease, and was moreover very active politically. 
Alcohol was excluded as a cause of the attacks, patient 
was always sober, limited his daily allowance of wine to 
about half a bottle, not exceeding this amount during the 
lumber auctions. 

CASE 111. JOURNAL NO. 134. Anamnesis and Status, 
October 12th, 1898. Miss X. Aet. 43 years, single. 
Mother living, 72 years old, well. Father died in 1884, of 
chronic spinal disease. A brother died of acute disease in 
early life, one sister living, very nervous. Father's family 
nervous, especially the father and one of his brothers, said 
to have been unusually irritable individuals, not easy to 
get along with. Patient's birth was normal. She was very 
delicate as a child, developed normally later on, readily 
recovered from children's diseases, Menstruated at 13, 
period regular and painless. As a child she had a tendency 
to outbursts of anger, was irascible. This improved later 
on, and her education met with no difficulties. Was a 
moderate student at school, not particularly gifted, but 
diligent. Refused several offers of marriage because she 
saw her aim in life in nursing her sick father and cheering 



The Origin of Paranoiac Delusions. 



315 



him in his protracted severe disease. When he died in 
1884, her sorrow was extreme, and patient appeared so 
exhausted mentally aad physically, that her mother was 
seriously worried. A recreation was secured by prolonged 
trips. Patient said to have been in good health up to 1898- 
In the spring of this year she moved to Weisbaden. 
Since father's death she had lived with her mother, whom she 
loved devotedly, the relation between mother and daughter 
being everywhere acknowledged as exemplary. The ladies 
had extensive agreeable social connections and were 
universal favorites. The climate did not at all agree with 
the patient. She suffered very much from the great 
exhausting heat in the summer of 1898, and complained 
of a number of nervous disturbances: insomnia, heaviness 
in the head, prostration, a dislike for mental exertion, 
anorexia, sluggish digestion. Became visibly worse, lost 
in weight. The condition dragged over several months, 
and changes in her behavior began to manifest themselves. 
She was extremely irritable, always restless, hurried and 
discontented. Withdrew more and more from society and 
showed an otherwise unknown mistrust. For days together 
she could not be prevailed upon to leave the house, and 
the mother was particularly struck with the fact that she 
would no longer tolerate religious assistance, which on the 
contrary excited her very much, so that she avoided church, 
entirely against her habits. About the end of September, 
she first gave her mother an insight into the condition of 
her mind. She accused two ladies of their acquaintance of 
hostilities, as follows: ''They are false friends, of course 
they do not let anything be seen in public, but they have 
forged an entire plot to push me out of the social circle, to 
drive me away from here by calumnies, and to throw me 
into despair. They will not rest until I am dead." Every- 
body was contriving to let her see that she had lost all 
esteem. Everything was being done towards her ruin. 
Moreover, she was no longer able to pray, as she had been 
fond of doing, without ever pondering over it. "I can no 
longer pray nor collect myself, they have robbed me of my 
faith, they have estranged me from the Lord, and now 



316 



Dr. Gierlich. 



they are taking advantage of it." Patient remained much 
of the time in bed, could not be prevailed upon to leave 
the house. 

Status: Patient describes with great animation how 
her best friends turned out to be false and aggressive 
enemies. They were both at work to render her impos- 
sible, to ruin her good name, and then to destroy her. 
The two had already formed an entire plot, and they kept 
on calumniating until the whole town knew of it. One 
would not notice it to speak to them, they acted in a very 
friendly manner. She neither sees nor hears it, nor does 
she observe it from signs or movements. She had been 
estranged from the Lord, robbed of her faith, she is now 
unable to pray. She must get away from here, she will 
not go out here. "They would be capable of anything." 
Patient is perfectly clear as to time, place, persons, speaks 
quite calmly and readily about things outside her delusions, 
there is no fluctuation towards abiaormal hilarity (euphoria) 
or sadness. She is only extremely angry and furious in 
the sense of her delusions and becomes violent to a degree 
otherwise unknown in her upon contradiction, especially 
towards her mother. "My mother permits everything, 
she does not defend me, she is also in the plot." She 
actually pulled her old mother's hair a few times, which 
would have been unthinkable outside her disease. Halluci- 
nations and illusions could not be determined. There was 
nothing of importance on the somatic side. Patient some- 
what below medium height, well made. Temporarily 
under-nourished. Near-sighted since her youth, No bodily 
anomilies. Pupils O. K. Sensation, motion, reflexes normal. 
Pulse 82, regular, full, not hard. Heart, kidneys, etc., 
without any pathological fundings. 

This condition persisted at the same degree until the 
middle of December, notwithstanding baths and narcotics. 
Then a perfect insight into the condition developed within 
five or six days. Patient was entirely transformed, became 
a refined and amiable lady, who could not understand how 
she had ever gotten such "crazy" ideas, and how she 
could have treated her mother, her dearest and best, in 



The Origin of Paranoiac Delusions. 



317 



such a fashion. No harsh word had ever been dropped 
before. She resumed her social relations, took a share in 
charity organizations, and acted quite naturally. There 
was no amnesia no reactionary hyperthemia, She was 
again at peace with the Lord and with religion. In the 
summer of 1899, the author advised that she should leave 
Weisbaden at an early date, in order to visit a hydrothera- 
peutic institution in Switzerland, at a higher level. This 
was done, and her health was fair. The summer of 1900 
was passed by the ladies in Weisbaden, with the same 
unfortunate outcome as in 1898. About the middle of 
August the general nervous disturbances returned in the 
former manner: insomnia, pressure in the head, anorexia, 
constipation, prostration, irritability, restlessness, etc. 
Before atrip had been decided upon, about the end of Sep- 
tember, the author found the patient again under the sway 
of her delusions. The two friends, surrounded by a perfect 
plot of strangers and acquaintances, were again using all 
means to destroy the patient by calumny, robbing her of 
her honor and her name. Patient always placed a very 
high valuation upon her (historically famed) title of 
nobility. The mother also was in the plot. At the same 
time, the incapacity for religious duties again manifested 
itself. She cannot pray, — so much they have been able to 
accomplish. Patient is extremely irascible and angry when 
her delusions are contradicted, becomes aggressive towards 
her aged mother. There is no depression, self-accusation 
or euphoria. Patent is perfectly clear and acts entirely in 
the sense of her delusions. She locks herself in, does not 
go out for fear she might be hurt in some way. "They 
are capable of anything; would instigate anybody." 

Following- the author's advice, the ladies promptly 
went to the same place in Switzerland, as in the previous 
summer. This plan proved a complete failure. The 
threads had already been open far enough. Certain per- 
sons from Wiesbaden, whom the patient knew only by 
sight, and who happened to be in the sanitarium, had 
already been at work to spread the net of calumny. Every- 
body had been told, and nothing but contempt was shown 



318 



Dr. Gierlich. 



her. The ladies soon returned and remained at home, The 
condition persisted at this level up to the third of Decem- 
ber. The patient then became quieter, could be talked to 
without violent outbreaks upon contradiction of her de- 
lusions, and in about eight days her insight was perfect. 
Patient is ashamed of her ideas, and unhappy about her 
conduct, especially towards her mother. Is again reconciled 
to the Lord and religion. Her insight is perfect. Patient 
began to resume her customary social relations, and had no 
feeling of interference. Hallucinations and illusions were 
never noted, patient denying them in both good and bad 
days. Somatic findings always negative. There is no 
reason to assume a deterioration of intellect, nor had the 
mother noticed anything in this direction. No abnormal 
fluctuations of temper. Patient was last seen by the 
author in April, 1901, in perfect health. She left town. 

All three cases concern individuals with faulty heredity, 
moderately gifted, but possessed by a high ambition, 
which endeavored to manifest itself according to individual 
conditions. In the prime of life, under the influence of 
general factors affecting the nervous system in particular, 
systematized delusions manifest themselves, as delusions of 
persecution, jealousy, etc., appearing abrubtly at certain 
periods, without melancholia or maniacal disturbances, after 
the patiente had been for two or three months under the 
sway of very severe neurasthenic symptoms. The pa- 
tient is entirely under the influence of his delusions, so that 
his disposition and actions are governed by them. The 
former is expressed by great irritability and irascibility, 
upon the slightest attempt to oppose the delusions. Other- 
wise, the patients are perfectly clear during these attacks, 
in regard to persons, time, place, etc. There were no de- 
lusions of grandeur. The delusions persisted at ful 
strength for several weeks, then the patients became 
amenable to reason, perfect insight appearing with 
relative rapidity, within two to four days, with 
subsidence of the irascibility, and without any reac- 
tionary anomalies. It was possible to prevent the return of 
the attacks by suitable measures, guarding against weak- 



The Origin of Paranoiac Delusions. 



319 



ening of the patient at a certain season, or at least the 
severity of the attacks could be considerably lessened. 
Under neglect of these precautionary measures, the attacks 
returned in their typical form with striking similarity, without 
evidence of a progress in the system of delusions. The 
second and third attacks presented a less violent reaction 
than the original attack. This may be partly referable to 
the better training of the surroundings, who were more 
calm in their interpretation of the condition and more san- 
guine about the prognosis. In part, the author is of the 
opinion that the patients were •somewhat more accessible to 
professional influence, notwithstanding their absolute adher- 
ence to their systematized delusions. Deepseated, progres- 
sive disturbances of a psychical or somatic character were 
not observed. The intelligence was not demonstrably 
diminished. There was nothing in favor of paralysis. The 
attacks are accompanied by a marked decrease in weight. 

Among similar observations reported in the literature, 
the first parallel must be drawn with Ziehen's case. Here 
also we find systematized persecutory delusions with great 
irascibility, without the influence of hallucinations, appearing 
periodically, with perfect insight in the intervals. Hamilton's 
case probably also belongs under this heading, periodical ap- 
pearance of persecutory delusions in a woman having 
Basedow's disease. Bechterew's patient likewise belongs 
here, since the occasional hallucinations and illusions were 
devoid of influence upon the systematization of the periodical 
delusions. This case is especially characterized by the ap- 
pearance of delusions of grandeur side by side with per- 
secutory delusions. In the other cases of periodical paranoia, 
hallucinations existed at the beginning- of the disease, and 
were not without influence upon the systematized delu- 
sions. However, it is stated by Kausch, that his patient's 
lack of judgment, and therefore the formation of the sys- 
tematized delusions could hardly be caused solely by the 
hallucinations — which were chiefly of an auditory char- 
acter — without the patient's even attempting to convince 
herself with the assistance of other senses. Kausch also 
accordingly does not hold the hallucinations alone respon- 
sible for the origin of the delusions. 



320 



Dr. Gierlich. 



Bleuler recently described 11 cases of periodical de- 
usions, 10 of which presented more or less marked symp- 
toms of manic-depressive insanity in the anamnesis, only 
one case being- entirely free. Blueler inclines to subjoin 
these cases entirely under manic-depressive insanity in 
the sense of Kraepelin. Chronic paranoia likewise is fre- 
quently introduced by depressive symptoms. Bleuler's point 
of view is possibly justified, and a favorable prognosis to be 
anticipated, whenever manic or manic-depressive mixed 
forms are demonstrable in chronic delusions. In those cases, 
however, in which the delusions, the salient feature of 
these conditions, develop gradually, entirely along the lines 
of paranoia, in the absence of manic or manic-depressive 
mixed symptoms — the course cannot be determined at the 
present day, and accordingly a separation of the mild 
forms from the unfavorable ones is not feasible in the 
opinion of the author. 

What do we learn from the above observations in re- 
gard to paranoia and its etiology? There are cases pre- 
senting the picture of paranoia, developing systematized 
persecuting delusions, with great irascibility, without 
fluctuations of hilarity and sadness, lasting for several 
weeks without sensory impairment, passing rather rapidly 
to perfect insight into the condition, with a tendency to 
periodical recurrence. The prognosis is favorable as re- 
gards the individual attack, but unfavorable as regards re- 
currence. When periodical paranoia is designated by 
Kraepelin as a contradictio in adjecto, this presumably 
means merely a difference of opinion in the naming of the 
above conditions; namely, are they to be summed up under 
the name paranoia or not. The author thinks that the con- 
ditions under present discussion cannot be distinguished 
from paranoia at the time of the attack, and are merely 
characterized by the absence of progression and the mild- 
ness of the course. Similar conditions prevail, as in the 
case of dementia praecox, the character of which was form- 
erly assumed to be invariably unfavorable, but appears less 
and less serious in the light of recent observations (Otto 
Diem) so that Kraepelin also mentions an outcome in re- 



The Origin of Paranoiac Delusions. 321 



covery, without or with deficiencies. Nevertheless, the 
designation has been retained. In a similar way, these 
mild, systematized delusions are sufficiently differentiated 
by the qualifying term "abortive" for some, and "periodi- 
cal" for others, from the severe forms of paranoia which 
pass from persecutory delusions to delusions of grandeur, 
and finally into dementia. 

Do these observations furnish information concerning 
the genesis of the delusions? Margulies discusses 
the divisibility of conscious processes into two com- 
ponents, namely, memories [and emotions. Complex con- 
ceptions are formed by the solid junction of similar mem- 
ory pictures, associated in times or space, with the corres- 
ponding emotions. The emotions*are at least twofold : firstly, 
those associated with the sensory impression of the memory 
pictuie; secondly, more accidental ones, depending upon 
the individual's frame of mind during the acquisition of the 
memory. Margulies endeavors to furnish this proof to the 
effect that some disturbances in the degree and course of 
these emotions constitute the source of the delusions at 
the outset of paranoia. Are these presumptions correct in 
the cases of these three patients? 

The first patient, about a year before the outbreak of 
the disease, was hurt by being passed over in certain 
promotions, showing that his official career was at an end. 
Given his ambitious character, he remained for a long time 
under the painful impression of this slight and under- 
estimation of his merit. He states that he often experi- 
enced difficulty in overcoming a feeling of incompetence, 
coupled with envy towards his fortunate rival, but suc- 
ceeded in doing so by comparisons with the amiable de- 
lightful manner of his colleagues and superiors. "We are 
poorly promoted, but well treated." When patient felt 
bodily and mentally worn out after the strenuous summer, 
these painful, tormenting feelings returned with greater 
strength and frequency. He would remain for days to- 
gether under their way, without being able to shake them 
off. Next, he believed he discovered changes and unkindness 
in the behavior of his superiors towards him, and thus one 



322 



Dr. Gierlich. 



fine day, the suppositous affair with the wife of his for- 
tunate colleague led to the outbreak of his delusions of 
injury and persecution. 

In the second case, the patient, a wealthy saw-mill 
proprietor, had married a poor girl, to the general surprise 
of the community. Patient states that he always sought 
extreme happiness in marriage and made his choice from 
pure affection, assuming the same to be true on his wife's 
part, for else marriage would be intolerable to him. Off 
and on, certain doubts would arise in the sense of the gos- 
siping neighbors, whether or not his wife had actually 
married him for love, or for the sake of a home, so that 
now he was in her way. As soon as he was together 
with her, and realized her gentle, clinging- manner towards 
him, his doubts as to her affection disappeared entirely. In 
the months when he was tired and worn out, these doubts 
as to his wife's affection attacked him more frequently and 
severely. For awhile, he fought against these painful feel- 
ings, but soon looked at everything she did from another 
point of view, and promptly stood entirely under the in- 
fluence of the jealous delusions. 

The patent mentioned under III is a society woman 
proud of her name, anxious to keep her title and social 
position free from blemish, very ambitious to play a leading 
part in her social circles and to arrange festivities in the 
interest of charity. These habits were seriously interfered 
with by the severe neurasthenia from which she suffered 
after the hot summer. She felt her incompetence, and saw 
herself forced upon several occasions to leave social gath- 
erings. Neither was she able to attend to her duties as 
president of various associations, all of which deeply grieved 
and annoyed her. She regarded her successor with bitter 
envy, got into a highly irritated condition, and was finally 
unable to repudiate the idea that her friends rejoiced over 
her misfortune and profited of the situation, in order to 
drive her away from her position and out of the town, 
ruining her by all sorts of calumnies. In this manner, 
she developed her persecutory delusions. The author was 
unable to ascertain definite particulars concerning certain 



The Origin of Paranoiac Delusions. 



323 



especially striking social "breaks" of the patient's, domi- 
nating the emotional sphere, but a number of painful 
situations were admitted, which troubled the patient for 
a long time, and over which she pondered considerably. 

The above observations, especially case 1 and 2, concern 
imaginations, corruptions which even in health are associated 
with a peculiarly distressing and troubled frame of mind, 
as they enter into consciousness. This frame of mind 
increases to such a degree in neurasthenic dispositions, 
which are especially susceptible to all negative emotions, 
that it dominates the individual in the sense of a compul- 
sory idea emotion. This conception is burdened with an 
intensely distressing sensation of unhappiness, anger, or 
envy, dominating the psychical behavior of the individual 
to such an extent that no associative or perceptive activitly 
(in the sense of Wundt) is capable of exerting a corrective 
and diverting influence by comparison or contrasting concep- 
tions, such as is constantly the case in physiological error. 
Moreover, the pronounced degrees of emotion do not permit 
the conception to drop below the threshold of consciousness. 
We are dealing in the first place with a process, with which 
we are familiar enough in a similar manner, as a compul- 
sory idea conception. On closer consideration it is seen, 
however, that it is not so much the conception which here 
forces itself upon the patient, as rather the associated frame 
of mind, which dominates the scene, and serves to distress 
the patient. "I could not get rid of my anger and unhap- 
piness, as soon as the idea appeared." When on the other 
hand, the conception entered into consciousness in well 
days, without the weighty, overwhelming emotion sensation, 
the patient readily succeeded in banishing it below the 
threshold of consciousness. Hence, we are here dealing 
with a compulsory emotion. Compulsory conceptions are 
known to pass over in certain cases into so-called insanity 
with compulsory conceptions, closely related to delusional 
conceptions; and this was extensively described by Bins- 
wanger (Neurasthenia.) The closer relations of compulsory 
ideas towards delusional ideas are further discussed b> 
Cramer, and especially by Friedmann. The latter says: 



324 



Dr. Gierlich. 



"Whether an object thought of becomes a compulsory idea 
or a delusional idea, is not dependent upon the kind and 
mechanism of its appearance, but depends in the first place 
upon the type of mind and the temporary mental condition 
of the thinking person." Loewenfeld expresses himself as 
follows: "Psychical compulsory phenomena constitute an 
extensive boundary region between mental health and the 
pronounced mental diseases, into which they pass only very 
rarely however, even in their severest forms." Accord- 
ingly, we might reach the conclusion that a similar compul- 
sory emotion, be it anxiety, expectancy, slight error, envy, 
etc., would lead to systematized delusions, provided it has 
the sufficient strength and duration. But there are certain 
weighty objections to this view, in the opinion of the author. 
It is a rather wide and arbitrary step from the objective 
interpretation of the situation, which appreciates the whole 
as a pathological irresistible coercion, to a failure to recog- 
nize this point of view, in the absence of all criticism. 
Every practitioner is acquainted with a number of cases in 
which severe disturbances in the emotional sphere (described 
by Margulies as the source of delusions) are observed to 
follow an accentuated conception in the sense of expectancy, 
anxiety, etc.; dominating the individual for a long time 
without leading to delusions. These conditions are fre- 
quently observed in officers of the army. 

Cases. A captain, patient of the author's, Aet. 41 
years, nervous ascendancy, himself generally nervous for 
years, was severely criticised by his highest superior at a 
review. He developed a highly neurasthenic condition, 
standing continuously under the painful impression of the 
occurrence, always in fear of his discharge, which would 
be his death. This condition lasted for years, without 
leading to delusions. A colonel, slight nervous heredity, 
was unlucky in the army exercises at the annual mancevre, 
and was criticised without having deserved reproof. He 
had hardly been nervous before, but soon developed a severe 
neurasthenic condition. Of high ambition— father of five 
children— not a wealthy man — he lived in constant fear and 
anxiety in regard to his discharge. Although this condition 



The Origin of Paranoiac Delusions. 



325 



was maintained for months at the same level, no delusions 
were noted. 

The following case even more closely resembles the 
observations of Margulies: A merchant from Holland, Aet. 
39, not much faulty heredity, self-made man, now has 
extensive business, which he manages with his wife. Patient 
became nervously irritable without visible cause, had insom- 
nia, gradually developed severe neurasthenia, was extremely 
restless and irritable. At the height of this state, he said 
that prosecution by the district attorney was threatening 
him, that he had ruined his business and his family. Patient 
made several attempts at suicide, tried to jump out of a 
moving train, and could only be restrained by violence. 
No signs of paralysis. After a short time, patient admitted 
under urgent persuasion that a year previously he had signed 
a blank check for a business acquaintance, without the 
knowledge of his wife. This acquaintance had meanwhile 
been declared in bankruptcy, and a prolongation of the 
check was impossible. He, the patient, being unable to 
meet the amount, he would be prosecuted by the district 
attorney and punished with imprisonment. The sum 
amounted to 15,000 florins. Payment of the debt was 
promised per telegram by his relatives, with the result that 
the pathological picture underwent an abrupt change, 
although the neurasthenia subsided gradually only. No 
delusions were observed notwithstanding the high degree 
of the anxiety and expectancy. 

Other cases are known, in which compulsory ideas 
persisted for a long time the patient always remaining 
aware of the outside abnormal compulsion. A gentleman, 
patient of the author's, has been suffering from this kind 
of an emotion for over ten years. He had accompanied his 
mother to a concert. Ten days later, she had an attack 
of pneumonia, from which she died. The patient has since 
remained under the impression of the sad reproachful feeling 
that he had not assisted his mother with the desirable 
promptitude in putting on her coat when leaving the con- 
cert hall, and that he had thereby caused her death. As 
a matter of fact, there was nothing to support this view. 



326 



Dr. Gierlich. 



Although the patient suffered severely under the weight of 
this emotion, there was no transition to delusions. 

Recently, Berze endeavored to prove in an important 
dissertation, based upon Westphal's views, that the leading 
part in the origin of delusions must be attributed to the 
intellectual rather than the emotional activity. Berze closely 
follows Wundt, explaining that "the psychopathological foun- 
dation of chronic delusions is a disturbance of the percep- 
tion, which consists in an interference with the process 
of raising a psychic conception into the internal viewpoint. 
This interference is said to induce primarily the idea of 
passiveness as a sequel to passive perception. In the second 
place, this interference results in the suspension of a series 
of perceptive acts, which take place without difficulty in the 
normal individual. In the third place, this interference 
results in delay of the sinking of (conscious) psychic con- 
cepts below the threshold of consciousness. This prevention 
of appreciated concepts from sinking below the threshold 
of consciousness, combined with the limitation of the con- 
scious concepts, is said to lead to compulsory faulty asso- 
ciations." The participation of "the idea of passiveness 
results in, erroneous relations to associations with the ego." 
The argumentation of these principles from the psycho- 
logical point of view is clever and convincing throughout; 
only the question arises why delusions do not occur with 
greater frequency in the course of neurasthenia, in which 
disturbances in the mechanism of the intellectual functions, 
as above described, are the rule (difficulty of raising a given 
conception into consciousness; interference with sinking 
below threshold of consciousness, without emotional basis.) 
The idea of passiveness, during the process of psychic 
perception, is shared by the healthy individual, according 
to Wundt; it is simply intensified in the above condition. 

It is a common complaint of neurasthenics that they 
suffer a good deal with difficulties in thinking and the course 
or sequence of thoughts; this disturbance causing them 
much distress. Again, it must be admitted that suggestions 
of systematized delusions are by no means rare in these 
cases, if attention is directed towards them: 



The Origin of Paranoiac Delusions. 



327 



Mr. X, assessor, Aet. 33, nervous family history, good 
mental equipment, led a very fast life as a young man, 
worked very hard between whiles, had influenza before his 
final examination, which he passed with a good mark a 
week after leaving his bed, This was followed by a severe 
attack of nervous prostration. Patient is unable to think, 
therefore does not care to converse, cannot discuss subjects 
relating to the law, which used to be mere child's play to 
him. Abstract thought is very difficult and painful. Memory 
good. Patient frequently shows suggestions of systematized 
associated delusions. One day he refused to enter the 
consulting room and began to pack his trunk. When finally 
persuaded, he said: "I must ask you first of all, if you are 
still willing- to treat me. 1 notice that I am troubling and 
disturbing you." "What makes you think so?" "It became 
perfectly evident to me as you came into the room this 
morning." (Author says that he was always particularly 
amiable towards the patient, knowing his sensitiveness.) 
He allowed himself to be talked out of his idea, but every 
few days he had some notion towards one or other of the 
patients, to the effect that they wilfully neg'ected him, 
that he was uncongenial and unwelcome, that they showed 
this by all sorts of hints, etc. Twice he confronted a gen- 
tleman in his room, asking him directly for an explanation. 
The others, of course, did not know how the patient got 
these ideas. After an explanation, peaceful relations were 
always re-established. This conduct was diametrically 
opposed to the gentle amiable character of the man. Patient 
at present does not work and lives under very favorable 
conditions. Author says he can readily imagine that in 
this case the ground would be well prepared for the develop- 
ment of systematized premonitory delusions under a strong 
emotional impetus, combined for months with a feeling of 
anxiety, expectancy, envy, etc. 

After all these observations and deliberations, it is 
intelligible that the author cannot identify himself with 
either of the two groups which at the present day are 
arrayed against each other as regards the origin of delusions 
in paranoia. This seems to him neither a purely intellectual 
disease, nor primarily referable to the emotions alone. 



328 



Dr. Gierlich. 



The correct solution of this problem probably lies in the 
middle. The foundations of the delusions, in the author's 
opinion, consist in disturbances of the frame of mind by 
violent protracted emotions of expectancy, suspense, anxiety, 
anger, envy, etc., in combination with an existing weakness 
of judgment towards these highly accentuated ideas. On 
the other hand, the associations and perceptive connections 
must take place in the normal manner, both per se and in 
their mutual relations (the foundations of the critical faculty) 
towards the less accentuated emotional ideas and conceptions. 
Mistrust is not an emotion in the above sense. It originates 
only as the result of the delusional interpretations, as 
pointed out by Bleuler and Specht, more recently by 
Schultze. The further course, as leading to recovery, 
arrest, or progression (delusions of grandeur and dementia,) 
depends essentially upon the brain-power, which determines 
whether or not the delusional interpretation extends later 
on to ideas not accentuated in the above sense, and whether 
or not it continues after the subsidence of the emotion. 
In which one of the three above mentioned components of 
normal judgment the disturbance first asserts itself, is still 
a matter of purely theoretical consideration. Friedmann 
assumes thinking in short associations, whereas Berze refers 
the primary impetus to the passive perception. As a matter 
of fact, the function of perceptive synthesis and analysis, 
imagination and intellectual activity in the sense of Wundt, 
is probably responsible in the first place, as the most 
important mental function. Being inhibited in its function, 
due to the strong outside sensation, the perceptive faculty 
presumably loses its objective standpoint towards the 
complex conceptions, as they arise with all the force of 
a suggestion, in mild otherwise not recognisable disturb- 
ances — leading to delusional conclusions in the sense of the 
conception. 

The cases so often quoted by Cramer, Berze and 
others, in which the emotional foundation cannot be demon- 
strated to the above degree at the onset of the delusions, 
become more intelligible on the basis of the author's 
assumption. It is intelligible that the two requirements 



The Origin of Paranoiac Delusion. 



329 



for the formation of delusions may approximately supplement 
each other, in such a way that the perceptive exhaustion 
in the above sense manifests itself only in connection with 
a very marked emotional accentuation, or in milder accen- 
tuations, respectively. 

As the author's article was being concluded, he received 
a paper by Ernst Schultze, in Bonn, in which the writer 
in his lucid manner urgently advocates the causative impor- 
tance of the emotions at the onset of paranoia, but proceeds 
to recognize a disturbance in the intellectual sphere in the 
sense of Gierlich's arguments: "Of course it is not main- 
tained that every intellectual disturbance is excluded in the 
development of paranoia, for it goes without saying that 
there exists a disturbance, under the influence of the emo- 
tional disturbances, the impressions are fixed from one 
point of view only, are rendered erroneous, resulting in 
observations which do not correspond to the actual facts. 
However, this does not imply a defect in the intellectual 
sphere, or a quantitative disturbance. The emotional 
accentuation of the newly developed conceptions is far too 
intense to admit of correction." Schultze further explains 
that paranoia in the true sense does not develop in imbe- 
cility and idiocy. These delusions are characterized by the 
absence of assimilation according to great uniform prin- 
ciples, and the condition is preferably referred to as idiocy 
with delusions. Hence, the paranoiac must be a "past 
master in the architecture of thought," who loses his power 
of correction towards the strongly accentuated emotional 
conceptions, the balance of his critical faculty remaining 
normal. 



EROTOGENESIS OF RELIGION. 



BY THEODORE SCHROEDER, 
63 East 59th Street, New York City. 

EJVERY definition of religion is resolvable into this: Re- 
ligion is man's conception of his relation to those 
among the supposed objects of his dependence, to which 
his relations seem so mysterious that he deems his ac- 
quaintance with them due to transcendental experiences. 
Man's gods are his conception of such objects of depen- 
dence, which, in turn, involve his explanations of the 
mystery. Symbolism and institutionalism in religion are 
but man's imperfect objectivations of these concepts. 
Idolatry is the worship of a man-made symbol in lieu of 
the concept symbolized, and is developed by a process of 
gradual and unconscious substitution, with a final conse- 
cration, and a belief in its being an incarnation of the 
diety. 

The God idea, like the idea of the good and the 
beautiful, is a mere abstraction, not an objective reality 
cognizable to man as such, but wholly, solely and unalter- 
ably subjective, finding its only justification in the feelings 
of man, though seldom so understood. The history of re- 
ligion is, therefore, but a record of man's objective mani- 
festations of such subjective states. Thus viewed, the 
study of religious phenomena is essentially a branch of 
psychology, and the methods of material science, adjusted 
to the order and relations of objective phenomena, are ap- 
plicable so long as we are examining the religion of others. 
The scientist must study the manifestations of religion as 
the alienist studies the utterances of the insane, namely: 
as a means of classification, and for the discovery of causal 
conditions within, as well as without, the individual. 

( 330 ) 



Erotogenesis of Religion. 



331 



Variety of religions is the product of evolution, a part 
of universal evolution. The difference between the individ- 
ual worshipfulness of some primitive peoples and our modern, 
highly-diversified, religious organizations, only exemplifies 
the law of evolution, which is ever a transition "from an 
indefinite, incoherent homogeneity to a definite, coherent 
heterogeneity." 

In criticism of Spencer, Lang, Taylor and others, in 
their efforts to interpret religion in terms of the law of 
evolution, it has been justly said: "However interesting 
these [their] theories may be, however much light they 
may shed upon the religious life of primitive and civilized 
peoples, the question, 'How did primitive man obtain con- 
ceptions that we call religious?' is not solved."* 

However, by applying the law of evolution to the 
known facts, we may be able to retrace the evolutionary 
process to the beginnings of religion, and having thus 
found the initial object of worship, we are in a better 
situation to answer the inquiries as to how, whence and 
why man acquired religious experiences and concepts. 

If we desire to retrace the evolutionary processes of 
religion to their origin, we begin by arranging the ob- 
jects of worship according to their evolutionary chronology. 
This is accomplished by classifying them as relatively close 
to or far evolved from the beginnings, according to the 
degree of complexity implied in the religious concepts, and 
the degree of conscious knowledge of man's relationship to 
his environment, which is implied from his choice of the 
objects of worship. 

Since continuing evolution is conditioned upon an ever 
widening mental horizon, that religion is nearest the primal 
deviation from the non-religious which implies the least 
knowledge of our environment. Because the worship of an 
infinite, purposeful, divine imminence implies a wider 
knowledge of the world and of the universe, than does the 
worship of isolated natural phenomena, therefore theism, as 
now defined, is conclusively proven to be a later evolution- 
ary development than the wo rship of a mountain or of 

*First Principles, Spencer, p. 407. Appleton Edition. 



332 



Theodore Schroeder. 



lightning. The first among the religions of which we have 
knowledge must be that one which implies the least or no 
conscious acquaintance with the objective. Judged by that 
test, it follows beyond all reasonable doubt that sex-worship 
must have been the very first form of our known religions, 
since the conditions of its development are wholly within 
each individual. 

When unconscious automatism was transforming to 
human self-consciousness, beyond all doubt one of its very 
first cognitions must have been the primal impulse that 
makes for progeny an accompaniment of sex-ecstacy. This 
is so for many reasons, and among them the conspicuous 
changes and periodicity of its manifestations, would compel 
an attention which a more uniform activity would escape. 
Then was the age of racial adolescence. Savages and 
children animate all things with a psychic life, and ascribe 
to a special volition all activities which excite their sorrow, 
joy, hope or fear.* It is a necessary inference that in 
primitive man this tendency was at least as pronounced as 
in present-day children. 

Becommg conscious that sex-impulse was uncontrollable 
by his own act of volition, man naturally assumed that the 
generative organs had a psychic life of their own, by which 
they know the how and why of their own activity, seen to 
be so well adjusted to the end of procreation. Necessarily 
such a man ascribed the phenomena of sex-excitement and 
sex-functioning to an intelligence not his own. Because 
he had not yet become conscious of his relation to his 
environment, he naturally gave that intelligence a local 
habitation within the virile member. As late as 1729, I 
find a Christian clergyman writing of it as the "receptacle 
of a manly soul."t 

Phallic worship was inevitable. To primitive man in 
racial adolescence the sexual mechanism and functioning 
is the first conscious, the greatest, and almost the only 
intense joy of his experience; the first visible and most 

*Chas. F. Hemingway, in v. II. Am. Anthropologist, p. 376. 
fSee Hibbert Lectures, 1891, pp. 62-68. Also Fact and Fable in Psychology 
and Taylor's Primitive Culture, for illustrative facts. 



Erotogenesis of Religion. 



333 



immediate ' course of life, the first object of conscious de- 
pendence; the first mystery presented to consciousness 
demanding solution and inspiring awe; the first sense per- 
ceived associate of his highest, his deepest and almost his 
only hopes, longings and joys, as well as the instrumen- 
tality of their realization. 

It was unavoidable that the solemn awe of sex-mystery, 
the seeming transcendence of sex-ecstacy, and the pre- 
dominance of a conscious-dependence upon sex for joy and 
life, all combined with the supposed intelligence ascribed 
to the sex-organs, would fuse into a worshipful reverence 
of the phallus, as the original, objective, intelligent and 
ultimate source of all that to primitive man was worth 
having. In the nature of things, therefore, these elements 
made sex-worship the first religion, and they are the 
essentials of all religion, even to this day. A growing 
knowledge has caused us often to change our opinions as 
to the situs of that other intelligence which controls our 
destiny, but the essence is still the same. When we shall 
have solved the mystery of generation, abolished the awe 
of ignorance, and no longer experience the ecstacy of love, 
religion will have ceased to be. In these considerations we 
find a complete answer to the question, "How did primitive 
man become religious?" 

Prehistoric archaeology has also contributed evidence 
to show that phallic worship is the oldest religion. A modern 
writer has this to say about our theme: "There appears 
to be a chance of this [phallic] worship being claimed for 
a very early period in the history of the human race. It 
has been recently stated in the Moniteur that in the 
province of Venice in Italy, excavations in a bone cave 
have brought to light, beneath ten feet of stalagmite, bones 
of animals mostly posttertiary, of the usual description 
found in such places, flint implements, with a needle of 
bone having an eye and point, and a plate of an argilla- 
ceous compound on which was scratched a rude drawing of 
a phallus."* 

There can be no objectivation of a concept, as in a 



*The Moniteur, June, 1865, quoted in The Worship of the Generative Powers. 



334 



Theodore Schroeder. 



drawing - , until man has become self-conscious. It, there- 
fore, follows from the very nature of our thinking processes, 
that man could not make a drawing of the phallus until 
after he had become definitely self-conscious of some of 
the phenomena of sexuality. Since with the genesis of 
such a consciousness the primal phallicism must have come 
into being, it follows that the drawing above referred to 
was made after the beginning and probably because of sex- 
worship. This easily fixes the existence of phallic religion, 
ages anterior to the known existence of every other kind 
of religious manifestation. 

Since the course of evolution is marked by a change 
"from incoherent homogeneity to a coherent heterogeneity," 
it follows that we are retracing the course of religious de- 
velopment so long as the proportionate homogeneity and 
its incoherence are on the increase. The end of this re- 
tracing cannot have been reached so long as the object of 
worship is an abstraction or a generalization, since both 
necessarily imply a prior acquaintance with, and probably 
a worship of the concrete. It would seem, therefore, that 
the initial object of worship must have been concrete. 
Neither could it have been the same identical con- 
crete object that first induced religion in each primitive 
man, since a conscious relation of the whole human family 
to the same object implies a very high degree of coherence 
between all. The ultimate of religious incoherence is reached 
only when the indulgence of religious sentiments is that of 
each man in a state of absolute religious isolation. 

Among all the historically known concrete objects of 
religious reverence only one will admit of the hypothesis, 
that all the conditions of its religious adoration were present 
in and for every man, and with him wherever he is, on 
every part of the earth, at the age of religious awakening, 
either individually or racially considered, and at every other 
time as well. That one object is the sexual mechanism. 
Only in the primal sex-worship of racial adolescence, when 
every man finds a part of himself to be the source of every 
religious essence and the object of his religious sentiments, 
can we find that ultimate incoherence and homogeneity 



Erotogenesis of Religion. 



335 



which the law of evolution conditions as existing at the 
time of religious inchoation. By this test, we again reach 
the conclusion that sex-worship must have been the first 
of all religions. 

The religious homogeneity which the law of evolution 
postulates as the condition of the primal deviation from the 
non-religious, demands that if sex is the generant of re- 
ligion, and this came about as an unavoidable consequence 
of the conditions of racial adolescence, that then all peoples, 
where religion has come into being, must have had some 
form of sex-worship at and near their religious beginnings. 
This means that at the times of its inchoation, a religion 
with a distinctive sexual foundation must have been 
geographically universal over the portions of the globe 
inhabited by native religious humans. That phallic wor- 
ship was thus geographically universal is the testimony of 
every serious student of this cult. 

Says Richard Payne Knight: "Those who wish to 
know how generally the symbol [of the phallus] and the 
religion which it represented once prevailed, will consult 
the great and elaborate work of Mr. D'Hancarville, who, 
with infinite learning and ingenuity, has traced its progress 
over the whole world. "* 

Another student of the subject, adds this testimony: 
"Of the extensive prevalence of this worship [of the human 
organs of generation] we have ample evidence. It occurs 
in Egypt with the diety Khem, in India with Siva, in 
Assyria with Vul, in Greece with Pan and Priapus, in the 
Scandinavian and Teutonic nations with Fricco, in Spain 
with Hortanes. It has been found in different parts of the 
American continent, in Mexico, in Peru and Hayti; in both 
these latter places numerous phalli, modelled in clay have 
been discovered, and in the islands of the Pacific Ocean 
on festive occasions, a phallus highly ornamented, called 
by the natives Tinas, is carried in the procession. "t 

Clifford Howard, another student of sex-worship, con- 
tributes this statement: While the highest development of 

*The Worship of Priapus, p. 16. 
tNature Worship, p. 12. 



336 



Theodore Schroeder. 



phallicism was reached by the ancient Egyptians, Assyrians, 
Hindoos, Greeks and Romans, proof of the existence of this 
form of religion is to be found in every part of the earth in- 
habited by man. Persia, India, Ceylon, China, Japan, 
Burmah, Java, Arabia, Syria, Asia Minor, Egypt, Ethiopia, 
Europe and the British Isles, together with Mexico, Central 
America, Peru and various other portions of the Western 
Hemisphere — all yield abundant evidence in support of the 
universality of phallic worship as a primitive form of re- 
ligion, and of the common origin of theological creeds."* 

These facts again confirm our former conclusion that 
sex-worship is the primal religion from which all others 
have evolved. 

We must further verify our conclusion, by determining 
whether the sequence of events implied in it corresponds 
with the natural order otherwise determined. In other 
words, can we verify the implication that emotional religion 
preceded the rational form. In the course of evolution the 
emotional life precedes that of conscious reason. Affinity 
and aversion, feelings of pleasure and pain, existed as an 
automatic reaction upon environment, long before they were 
the basis of conscious ratiocination. It is not thinkable 
that in its specialization as to religion, this order of events 
should be reversed, and rational religion antedate and 
develop the emotional. 

The spontaneous unreflecting feelings of joy and terror 
which are displayed by even lower animals in the presence 
of certain natural and mysterious phenomena, is a funda- 
mental fact of religion, and the first mysterious joy to arise 
into consciousness would be that connected with sex. 

When in the course of evolution man attributed to it a 
psychic personality, analogous to, but more exalted than 
his own, the sentiment he experienced toward it and his 
instinctive groping in quest of an agreeable relation with 
that mysterious being constituted his religion. Conscious | 
reasoning was not invoked until long after. When man i 
has become self-conscious and capable of introspection, and 
when he seeks to explain his emotions and his relation to i 

*Sex Worship, p. 12. 



Eroto genesis of Religion. 



337 



their supposed source, he first begins conscious reasoning 
as to any phase of his religion. Not until then can he 
seek for the establishment of any ideal relation with a 
mysterious higher power. Thus science and philosophy are 
but the rationalized expurgations of religion. What is still 
unexplained is the only exclusive property of the church. 

As we can draw no exact line between health and disease, 
so neither can we draw such between the unreligious and the 
religious stages of evolution, because they so gradually 
shade into each other. The infant in its cradle automatically 
responding to an agreeable stimulus when its mother ap- 
proaches, stretches forth its arm imploringly with the at- 
titude of mind that would propitiate, long before it has 
taken to reasoning either as to its relation to, or the char- 
acter of its mother. So did man in obedience to his emo- 
tions automatically seek an adjustment to the mysterious, 
at first within and later without himself, which consciously - 
sought adjustment is religion, long before he expended any 
conscious effort toward the solution of the mystery, — the 
contemplation of his object of adoration, — his God. 

Therefore we must conclude that the conception of 
! divinity did not engender religious sentiment, but rather 
' that the presence of mysterious emotions brought man to 
believe in the existence of gods and subsequently, in ex- 
planation of his emotional states, to reason as to the 
| divine nature. "The truth is that in the metaphysical and 
! religious sphere, articulate reasons are cogent for us only 
: when our inarticulate feelings of reality have already been 
I impressed in favor of the same conclusion."* 

No matter how we define religion, its emotional states 
long preceded the effort at a rational explanation for their 
existence and relations. Religious emotionalism, preceded 
rational religion, and this, again is as it must be if religion 
had its beginning in sex-ecstacy. Among all the objects 
of religious worship, only the phallus can supply all the 
conditions necessary for a subjective emotional religion, 
such as must always precede a reasoned view of man's 



*James' Varieties of Religious Experience, p. 74; also Prof. T. Thomas' Sex 
and Society, p. 118. 



338 



Theodore Schroeder. 



relation to his physical environment, such as could induce 
the worship of any portion of it. 

In the return from the zeal of intolerance back to 
rationality, hospitality is extended to differences of opinion 
as to economics, science, government, etc. The last two 
fortresses of bigotry are the belief in spiritual existence and 
sexual ethics. Even with persons in whom all semblance 
of religious doctrine or observance is dissipated, and an 
unlimited hospitality for intellectual differences is allowed 
upon practically all questions, the last remnant of bigotry 
will be certain to be an intolerance for differences of opin- 
ion as to sex ethics. 

It is a significant feature that the only inter-human 
relation not of necessity associated with or developed 
through religious theories, and which is accredited "sacred" 
or "spiritual" is the relation of men and women. Even 
the scientific religionist who can find "spirituality" almost 
nowhere else, can still discover a "spiritual" significance 
and "sacramental" character in marriage. If our theory is 
correct we should find it so. All the frenzy of fanaticism 
would then be a mere religious superstructure to disordered 
nerves, finding its religious element in the passional centers 
of physical organism. Since it is the law of devolution 
that the last acquired functions are the first to disappear, 
it follows from the fact that sex-superstition is the most 
persistent of all superstitions, that it is the source of all 
superstitions. 

If, racially speaking, religion had its origin in a misin- 
terpretation of an unidentified sex-ecstacy, it would seem 
to follow that some of this essence must be still present as 
one of the unrecognized elements in the individual experi- 
ences of the religious enthusiast. That is true, as also is 
this, that whatever is conspicuously true of all great re- 
ligious enthusiasm is in lesser degree true of all distinctively 
religious experience. What are the facts in this respect? 

Many years, devoted to the historical study of religious 
revivals, enthusiasms and abnormities leads me to this 
conclusion: Every intense and widespread religious revival 
has produced increased sexual irregularity. Every concerted 



Erotogenesis of Religion. 



339 



effort at the establishment of compulsory sexual excesses, 
either of repression or indulgence, has found its warrant in 
religion and its beginnings amid religious excitement. 
Every known type of sexual perversion, from salist lust- 
murder — up and down — has been credited with the en- 
dorsement of some god, and advocated and practiced by 
some religious society. Every organized effort toward 
ostentatious sexuality has found its justification in religion. 
Here, I have in mind those numerous small sects, such as 
the Adamites, with whom parade or worship in nudity was 
esteemed a duty to God, and those other anomalous creat- 
ures who go about wearing badges or uniforms, which un- 
ceasingly and ostentatiously advertise their "chastity." 
Were persons to announce through the newspapers their 
unseducible virginity, we would believe them sexually in- 
sane. When the same end is accomplished by conventional 
monastic methods of giving publicity to the same boast, we 
think nothing of it, only because we have become accus- 
tomed to it. 

From the time of the pre-historic sex-worship of primi- 
tive peoples to this very hour, the desire to regulate other 
people's sexual affairs has been the most zealously pur- 
sued of all the ambitions of religious societies. 

If then this mad overvaluation of the divinity, sacred- 
ness, spirituality or sinfulness of sex is a universal con- 
comitant of the frenzy of religious fanaticism, it would 
seem to follow that there must be a good deal of undifferen- 
tiated sensuality in all religious enthusiasm of lesser de- 
gree, and this again confirms the conclusion, that in so far 
as religion is still a personal experience, an emotion, in- 
stead of cold and passionless science, to the extent that it 
is a matter of "love," as is often proclaimed, it is again of 
erotic origin. 

Once realizing fully that man's religion found its origin 
and warrant within himself, and that of necessity the evo- 
lutionary modifications were impelled by similar environing 
conditions, it follows that these facts will explain the 
similarity of the religious product on various parts of the 
earth. This involves a reversal of our method of studying 



340 



Theodore Schroeder. 



the migrations of man. Owing to the myths about the 
the creation, it was once thought necessary to explain all 
similarity, whether religious or otherwise, as the product 
and evidence of a common Adamic origin. 

Now, that we accept universal evolution, we must 
come more fully to appreciate the fact that the evolutionary 
development of life may have reached the human, self- 
conscious stage in many different places at substantially 
the same era, and that the similarities which we find 
among different peoples are the result of a likeness in 
evolutionary materials and forces, and not evidence of a 
common ancestor; nor will they hereafter submit to being 
tortured into an explanation consistent with such discarded 
Adamistic monogenism. 

It used to be argued that the various systems of wor- 
ship in different parts of the world corresponded so closely, 
both in their evident import and in numerous points of 
arbitrary resemblance, that they cannot have been struck 
out independently in the several countries where they have 
been established, but must have all originated from one 
common source. The latter part of the argument is good. 
The error consisted in assuming that the common source 
must have been geographical, instead of looking for it in 
the very nature of every individual man, in the general 
and all important sex instinct. 

The practical universality of Ophiolatreia, demonstrates 
only its evolutionary proximity to the primal sex-worship. 
The probative force of a general similarity in myths con- 
cerning the fall of man, through the seduction of a serpent- 
tempter, only tends to show the sex-origin of serpent wor- 
ship, and to illustrate the uniformity of evolution. Same- 
ness in these myths no longer conduces toward their ac- 
ceptance as different relations of the same historical fact. 

There is still another consequence which follows from 
the subjective origin of religion. It furnishes a new ex- 
planation for that, all but, universality of religion. 
Heretofore this fact, because its relation to the sex-feeling 
was unrecognized, induced the conviction that religious 
ideas are innate. Out of this was evolved the notion 



Erotogenesis of Religion. 



341 



about the existence of certain intuitive first principles of 
which, or through which, because of their supposed origin, 
we were said to have inherent direct knowledge of God. 
The subjective and sex-origin of religion explains this 
universality and alleged innateness, so as to destroy utterly 
the deduction formerly made as to their infallibility of such 
testimony in favor of the objective verity of religious 
concepts. 

For the foregoing reasons, among many others, 1 con- 
clude that religion came into being by ascribing to the 
sexual mechanism a separate, local intelligence, which, 
coupled with a misinterpretation of the seeming transcen- 
dence of sex-ecstacy, resulted in the apotheosis of sex- 
functioning, and the sexual organs, and that all the mani- 
fold forms of religion are to be accounted for only as the 
diversified products of evolution, resulting wholly from 
physical factors and forces, operating upon man under 
different conditions. 



THE RELATION OF CEREBRO-SPINAL FLUID 
TO EPILEPSY. 



BY C. H. HUGHES, M. D. 

HOUSE (etiology and pathology of epilepsy major, 
Phila. Med. Jour., Vol. v., 1900) found in five 
autopsies, after status epilepticus an excess of cerebro- 
spinal fluid in each, and regards this excess of interventri- 
cular fluid as the cause of the convulsions and status. 
He compares the symptoms of epilepsy with those of other 
diseases which produce or are accompanied by convulsive 
seizures resembling more or less the seizures of epilepsy, 
hysteria, tetany, infantile, puerperal and uremic eclampsia, 
alcoholism, cerebral hemorrhage, and the apoplectiform and 
epileptiform convulsions of general paresis. Epileptic seizure, 
epileptiform paretic convulsion, alcoholic convulsion, or 
cerebral hemorrhage convulsion present marked similarity. 
"In the brain of an alcoholic there is an excessive quantity 
of cerebrospinal fluid, the ventricles are distended, the 
brain substance drips . with fluid, and the membranes are 
dropsical. This is called the 'wet brain.' In general paresis 
the ventricles are distended with fluid, there is an increased 
quantity of fluid in the subdural space, and the whole 
brain is surrounded with an excessive quantity of turbid 
cerebrospinal fluid." In these conditions the excessive 
fluid seems to House to be the logical cause of the symp- 
toms of these diseases, which he regards as pressure 
caused results. 

Besides these necroscopies, House's conclusions are 
drawn from a large number — approaching three hundred — 
epileptics, alcoholics and paretics. Bonar, in the December 
number Jour, of Ment. and Nev. Dis., has, with rare 

( 342 ) 



The Relation of Cerebro- Spinal Fluid to Epilepsy. 343 



neurological discrimination, singled out this excellent article 
for analysis and gives among others the following of House's 
conclusions : 

(2) An increase of cerebrospinal fluid would readily 
account for the seizures. In many instances it is analogous 
to the marked increase of fluid in the crania of alcoholics 
and paretics, and is not dissimilar in clinical effects to the 
more localized lesions of hemorrhage or abscess. 

(3) This fluid, physiologically subject to more or less 
variation in quantity from day to day, is fully capable of 
pathologic increase, and from analogy must bear exciting 
relations to the convulsion. 

(4) Its increase is probably gradual, and to this we 
may ascribe the auras. 

(5) Its absorption probably begins with the third stage 
of the convulsions (relaxation and coma), and if this fails, 
repeated convulsions {status epilepticus) ensue. 

(6) Its superabundance may be due to lymphatic spasm, 
or to marked disturbance of equilibrium between lymphatic 
and general circulatory activity, which may be favored by 
heredity, toxemia, or any of the recognized predisposing 
causes. 

(7) This creed applies to the so-called idiopathic 
epilepsy, as distinguished from the convulsion of the Jack- 
sonian epilepsy, although even in such cases this condition 
will help to explain some otherwise unexplained symptoms. 

This is an exceedingly plausible conception of epileptic 
convulsion causation, and one likely to prove quite as ac- 
ceptible to the neurological mind as the auto-toxicity theory, 
though the latter need not be cast out beyond the back- 
ground of a remoter causation of possible toxic vaso-motor 
paralyzing power producing the interventricular distension 
and subsequent arteriole contraction in the psycho- motor 
convulsion areas of the brain. 

Doctor Marc Ray Hughes, in a paper read before the 
Mississippi Valley Medical Association, October 11th, 1905, 
has called attention to this aspect of the pathology of 
epilepsy and epileptoid, though he maintains the initial 
stage to be, as has been of late years generally conceded 



344 



C. H. Hughes. 



and as the present . writer has maintained for decades, if 
not priority, an arteriole vaso- motor spasm from some source 
of cerebral excitation, probably auto-toxic, with cerebro- 
pathic predisposition. 

Epilepsy is a functional vaso-motor disease, an alter- 
nating vaso-motor condition of transitory paresis or paralysis 
and irritation, the irritation causing contraction of the 
arteriole supply of the convulsive area involved and the 
extreme ventricular dilations, caused by excess of cerebro- 
spinal fluid in them, producing the coma and comatose 
symptoms. 

A trauma or a blood toxine (auto-toxine or chemical, 
like alcohol, camphor, etc.) or a peripheral irritation, intra 
or extra intestinal, tapeworm, lumbricoids, fistula in ano, 
etc., causes first a paralyzing impression on the vaso- 
motor mechanism of the brain's blood supply or on the 
heart (cardiac epilepsy) causing the excessive pouring out 
of the cerebrospinal fluid into the perivascular spaces and 
ventricles of the brain. 

"The cause of the spasmodic paroxysm is also the 
cause of the removal of the first cause of the epileptic con- 
dition, viz.: the vaso-motor paresis and consequent pouring 
out in excess of the interventricular and perivascular space 
fluid into their natural receptacles in the brain. Whatever 
condition of the organism may cause first a paresis or 
paralysis of the vaso-motor mechanism so as to permit 
excessive filling of the ventricles to the point of such de- 
gree of distention as will bring vaso-motor irritation of 
the brain arterioles, will develop an epileptic or other 
convulsion. 

"A trauma, a toxicity of the blood, a peripheral irrita- 
tion apparently transmitted from the surface or from an 
internal organ will do the same (gastric, uterine, rectal, 
etc.) The recurrency which characterizes epilepsy is due 
to a peculiar morbid vaso-motor impressibility acquired by 
frequent repetitions of the cause and by hereditary im- 
pressibility. 



The Relation of Cerebro- Spinal Fluid to Epilepsy. 345 



"No epileptic brain where death came in the status 
has ever been found with undistended ventricles, and all 
known causes of epilepsy have produced this state of brain. 
Inebriety, general paralysis, cephalic traumatism, toxic in- 
fluence organically generated or taken from the animal, 
vegetable or mineral kingdom, and psychic influences have 
produced this state and phenomena, alternating of the 
vaso-motor nervous system whenever epilepsy or epileptoid 
symptoms have resulted." 



THE ALIENIST ON THE WITNESS STAND. 
UNSCIENTIFIC RULING OF THE COURT 
IN THE THAW CASE. FALLACY OF 
THE LEGAL "KNOWLEDGE OF 
RIGHT AND WRONG TEST 
OF INSANITY," ETC. 



By C. H. HUGHES, M. D., 

St. Louis. 

THE singular and unjust contention of Prosecuting Attor- 
ney Jerome, and this contention sustained by a ruling 
of Presiding Justice Fitzgerald, that "prima facia evidence of 
insanity must first be submitted through expert testimony 
before facts from other sources tending to show insanity 
can be admitted into the testimony, is, from an expert 
alienistic standpoint, violative of the just rights of the 
defense, the rights of psychological science and of experts 
therein whose need it is, and duty to have all available 
facts upon which to base a sound judgment on a question 
of sanity or insanity. The entire life biography of the 
person supposed to be insane and entitled to the immunity 
of insanity before the law, is involved in this question, for 
insanity is a matter of character change and disease. 

Another error and injustice to the prisoner suspected 
of insanity, and to the alienist experts summoned in court to 
determine if insanity exists, or has existed in the mind of 

( 346 ) 



The Alienist on the Witness Stand. 



347 



the accused, is the exclusion of conversations between wit- 
nesses and prisoner, as if the oral and verbal symptomatology 
were not essential to the diagnosis of insanity. Such evi- 
dence delivered to a psychological expert during his medi- 
cal examination is not in the nature of the legal heresay which 
ought to be ruled out in ordinary questions of evidence, 
but it may or may not prove symptomatic, like the interroga- 
tion of the eye, the ear, the psychic reflexes, the gestures, 
attitudes, sphygmographic tracings, pulse arterial states, res- 
piration, delusion, etc. Delusion is often revealed by speech 
and writing, gesture or attitude, etc. 

When a possible psychological problem presents to the 
alienist expert for solution, the expert should have access 
to every means of enlightening his observation and judg- 
ment in behalf of the prisoner and his interests, who is 
presumed innocent until proven guilty, by reason of crime 
conceived and executed by a sound and healthy brain and 
mind, or in behalf of the interests of the commonwealth, if 
simulation is suspected and sanity a probability. 

The prosecuting attorney and the presiding justice in 
this case, prejudiced the cause of the accused and violated 
the rights and necessities of psychological expert science by 
themselves, deciding the vital point that conversations can- 
not be taken into account in determining- mental status be- 
fore experts had decided, while it is a clinical fact that "by 
words sounding to folly, much, if not most insanity, is 
primarily suspected*" and often confirmed, notwithstanding 
that the actions of the insane, as of the sane, sometimes 
"speak louder than words." 

It is both by speech and action, with objectively dem- 
onstrated change of organism affecting the brain and mind, 
that science endeavors to form its judgment securely in a 
case of possible mental aberration, facts observed after and 
before, as well as at the time of apparent crime, or ques- 
tionable propriety or morality of any kind, to see if it be 
due to disease or to causes and conditions beyond the 
legitimate jurisdiction of medical science. 

The following extracts from stenographer's report will 

♦Isaac Ray. 



348 



C. H. Hughes. 



illustrate our contention of the court's error and the injus- 
tice done the prisoner and psychiatric science. 

Superintendent of the State Hospital for the Insane at 
Binghampton, N. Y., after outlining his experience as an 
alienist, said he had visited the defendant in the Tombs 
six times, the last time October 3. 

"On the first visit I talked with him, but did not 
make a thorough examination. 1 observed that he was 
suspicious, reticent and apprehensive. He was fearful that 
he would be declared insane. After a general conversa- 
tion I made an arrangement for a future visit, which led to 
a second examination. On September 19, 1 went to the 
Tombs with Dr. Evans, of the insane hospital at Morris 
Plains, N. J., for the purpose of making a thorough exam- 
ination. 

"What did you observe on this visit? 

"Mr. Thaw was brought in, and we had just stated 
the object of our visit, when Mr. Thaw turned on his heel 
and abrubtly left the room, notwithstanding that it was un- 
derstood plainly beforehand that we were there to ex- 
amine him. 

Justice Fitzgerald, on motion of District Attorney Jer- 
ome, ordered that all of the answers after the words 
"room," etc., be stricken out. 

Mr. Jerome admonished the witness that "no conver- 
sations were wanted," and the Court directed him to re- 
relate only what he observed. 

"Without stating any conversation, Doctor, tell us 
what you observed, asked Mr. Delmas. 

"He abrubtly left the room. 

"Did you observe anything else? 

"Yes, 1 observed more, but it was all in his conversa- 
tion." (And conversation is a legitimate subject of ob- 
servation in such an inquiry.) 

Mr. Delmas and Mr. Jerome then had a long argument 
on the law covering the matter of expert testimony. 

Mr. Delmas argued that the declaration by Thaw 
tended to show his state of mind at the time the action 
complained of was committed, but all he desired from the 



The Alienist on the Witness Stand. 



349 



witness now on the stand was an opinion as to the de- 
fendant's condition at the time of his examination in Sep- 
tember. He would ultimately show his condition on June 
25, 1905. Several authorities were quoted from. 

District Attorney Jerome argued that the mental con- 
dition of Thaw at the time of the examination was not ma- 
terial. The only thing that was competent, he said, was 
testimony to show Thaw's mental condition at the time of 
the shooting and at the time when his wife told him the 
the stories which the defense claims unhinged his mind. 

At the conclusion of the argument, Justice Fitzgerald 
said he could make no ruling because there was no ques- 
tion pending. 

Mr. Delmas than asked Dr. Wagner to go over the 
details of his second visit, and give the conversations. Mr. 
Jerome objected and was sustained. 

"When did you make your next visit to the prisoner?" 
asked Mr. Delmas. 

"I think it was on September 22, 1906. 

State what examination you made. 

"The examination consisted of certain questions I 
asked him and his answers to them. 

"You must not give conversations, said Justice Fitz- 
gerald. 

"Was there anything else? 
"Yes. 

"Wait a moment, Doctor, interrupted Mr. Delmas. 
Were those questions necessary to ascertain the mental 
condition of the defendant? 
Yes, sir. 

"Then please state what those questions were. 
JEROME'S OBJECTIONS. 

"Did these questions and answers put to the defend- 
ant refer to his past mental state or his condition at the 
time of the examination? 

"Both. 

"Can you separate the questions and answers as be- 



350 



C. H. Hughes. 



tween past events and his condition at the time of the 
examination? 

"To a certain extent, yes. 

"Please state the questions and answers, as to his 
condition at the time of the examination." 

Mr. Jerome objected, and was sustained. 

"Well, doctor, what did you observe or what did 
you do? 

"We took Mr. Thaw to where the light was strong. 
He watched us closely and would not be placed in such a 
position where he could not have seen both Dr. Evans and 
myself under his eye all the time. We asked him certain 
questions as to his life history, etc. 

"What were your scientific deductions as to the man's 
mind?" 

Mr. Jerome objected, saying the examination had not 
gone far enough for that, and was sustained. 

"You put to him certain questions and received certain 
answers; was that all? 

"As I remember it, that was all. 

"When did you next examine Thaw? 

"The next examination was on Sept. 27, and was in 
part a continuation of the previous one. Dr. Evans and I 
then took up the physical examination. 

"What did it consist of? 

PHYSICAL EXAMINATION. 

"The color of the hair, the general contour of the 
head, the expression of the eye, the condition of the heart, 
the reflexes and the state of the pulse. The matter was 
carried on in much detail. At the end of an hour the pa- 
tient was exhausted and we deferred further examination. 

"When was the next examination? 

"On October 3. We went over some of the ground of 
the former physical examination and also went into the his- 
tory of the case, and the family history. This examination 
also lasted an hour. 

The final examination was made October 8. We re- 



The Alienist on the Witness Stand. 



351 



viewed the proceedings of previous examinations and went 
into this story of the case in more detail, including the 
events of June 25th. This examination lasted for an hour 
and a half. 

"Doctor, from your examinations during six visits^ 
could you form an opinion of the then mental condition of 
Mr. Thaw. 
Yes. 

"Did it enable you to form an opinion of his mental 
condition on June 25? 
"Yes. 

"What was that opinion?" 

At this point Mr. Jerome objected and confused the 
witness, and made him say that his opinion was based on 
hearsay, the doctor doubtless referring to what he had 
heard from Thaw, and to what had entered his mind in 
addition to what he had elicited from personal examination, 
he evidently not being able at the time to say, what was 
probably the fact, that he made his opinion from what he 
had obtained by his examination, and what he had heard 
■ not in evidence only confirmed. 

"Doctor, your opinion," he said, "is based partly on what 
you observed and partly on hearsay and the family history, 
is it not? Your opinion as to Thaw's sanity is part based 
on matters not in evidence, is it not? 

"Yes. 

"To a considerable extent, is it not? 
"Yes. 

"As a matter of fact then, Doctor, you could not state 
an opinion after excluding the hearsay facts that were 
stated to you, as to this man's history, etc? 

"No, sir. 

"Then 1 submit, Your Honor," began the District 
Attorney, but he was interrupted by Mr. Delmas, who said 
I he would withdraw the question and frame a hypothetical 
jl one. 

In the meantime he asked that something be done to 
relieve the atmospheric condition in the courtroom, which, 
•[ he declared, was oppressive. Justice Fitzgerald declared 



352 



C. H. Hughes. 



a five minutes' recess. All left the room and the windows 
and doors were thrown open. 

Thaw whispered with his counsel and laughed merrily 
while leaving. 

The whole proceeding shows the wrong and the judi- 
cial fallacy of putting alienist experts on the stand to pro- 
nounce on a case of insanity when the facts are not all in, 
and proven before the question is put, or not assumed 
and offered to be proven from the evidence. 

When and where life and liberty hang upon the possi- 
bility of a delusion to be proven, a false judgment of the 
mind and the mind itself probably diseased, the conversa- 
tions of the party under examination for insanity, though 
not germane to any other thing in the trial or to any logi- 
cal premise in the cause at issue, as laid down by coun- 
sel, may reveal to the psychological expert the true nature 
of the mind under inquiry, whether morbid or otherwise, 
and these conversations may relate to matters otherwise 
irrelevant, except as the expert may need them as a basis 
on which to form a conclusion as to the mental status of 
the party under arraignment. 

The mind, through speech or song or pen, reveals its 
soundness and accuracy of psychic tone, as a musical in- 
strument does its capacity for harmonious sound, and the 
expert musician tests the musical instrument in a manner 
peculiar to the exactions and suggestions of his special 
skill and knowledge of the instrument's aptitude, capacity 
and power, and he does it by touching the keys or strings 
or otherwise sounding the notes of harmony or discord. 
He examines the instrument in his own way to find out if 
it is normal in tone and tune, like the normal, well- 
ordered mind, or whether it jangles out of tune and harsh, 
or even sweetly, but inharmoniously sweet, like the dis- 
ease-disordered mind may do. 

And he is allowed his own way about the method of 
examination to test its real condition and value. He may 
even ask who made it, and how and when and where. 
How long it has been put in service, and what manner and 
extent of service it may have been subjected to, and he may 



The Alienist on the Witness Stand. 



353 



examine the sounding board, if it be a piano, and test each 
individual string in its own way, as well as keys and 
pedals, stops or attachments, if it be an organ. He is per- 
mitted, as an expert on musical instruments, to know of its 
remotest heredity with the the piano or violin, if it be a 
Chickering or Stradivarius origin. No honest person who 
might wish to get at a correct knowledge of the real con- 
dition and value of such an instrument, would put ob- 
stacles in the way of its true condition and worth being 
discovered. 

In the Thaw trial, testimony as to a peculiar will 
made by Thaw, and whose peculiar nature in its singular 
provisions as the defense maintained, would show a state 
of unsoundness of mind no more remote than at the time 
of Thaw's marriage to his present wife (Evelyn Nesbit 
Thaw) in 1905, was objected to, and the objection was 
sustained by the court, though these facts, and the story 
of Evelyn Thaw's seduction were subsequently admitted. 
They should have been allowed to go to the expert in the 
hypothetical case in the beginning, as proper material on 
which to base a diagnosis of the sanity or insanity of 
Thaw. Everything in word or act that may throw possible 
light on symptoms of mental disease should be germane in 
an inquiry as to insanity or feigning insanity. 

The court in this peculiar procedure, to the mind of an 
alienist expert, even decided before the trial was half way 
through, not in fact more than fairly on its way, so far as 
the examination of witnesses were concerned, before the de- 
fense had time to develop the possible insanity side of its 
case, and after ruling out essential facts and requiring med- 
ical experts to be sworn before important facts needed by 
them upon which to decide the mental question, were 
brought out, declared the insanity plea was not established, 
as if a possibly insane man has no rights to evidence of 
his insanity that a court is bound to respect, especially 
where the possible malodorous or immoral reputation of a 
party not on trial must be protected. 

The will, showing as it did psychoasthenic dread of 
assassination and real or delusioned belief that his wife's 



354 



C. H. Hughes. 



life was in danger of death or drugging and his belief, real 
or imaginary, that his wife and other women friends had 
been grievously wronged, his singular financial provision for 
these really or falsely (delusionally) believed wronged 
women, show either a real moriphobic dread or a feigned 
fear of death, and should all have been promptly submitted 
to the opinion witness. 

Under the dominance of a morbid imperative concep- 
tion, the psychic offspring of his thanatophobia, he could not 
wait even till a day after his singular marriage might be 
consumated before making this peculiar will. The haste in 
the making, and all the circumstances connected with the 
execution of of this singular testament, which ought not, in 
the prisoner's interest, to have been ruled out, as it was 
at first, even though the name of Stanford White might 
have had to be excluded, were essential to the full force 
and value of the medico-legal testimony, in his interest and 
due him, as a possible insane man, at the mercy of the 
court and in justice, right and law demanding the court's 
protection. For "municipal law," according to that high 
authority that to this day guides, or should direct and bind 
the ruling of courts and the deliverances of juries, is "a 
rule of action, prescribed by the supreme power in a state, 
commanding what is right and prohibiting what is wrong." 
It is better that many criminals should go free by the 
rulings of justice tempered with mercy, than that by harsh, 
unmerciful, judicial deliverance of a court with power over 
life and death, an innocent man should be punished for an 
apparent crime of disease-impelled fatal violence. 

In this Thaw trial, words of judicial wisdom, tempered 
with merciful consideration for a possibly insane prisoner, 
should from the beginning, have dropped from the bench 
"like the gentle rain upon the place beneath," in behalf of 
the just rights of the hapless prisoner who sat in his 
place, apparently already condemned by the court in the 
beginning of the trial. For it said thus early in the trial, 
and in the presence of the listening jury, "Thaw's insanity 
is not established," as if it were in the legitimate and 
morally right province of the court to make a medico- 



The Alienist on the Witness Stand. 



355 



psychological diagnosis in lieu of the medical experts. As 
if it were within the province of a judge to decide so 
important a question as that of insanity on what he, a non- 
medical man, unauthorized by law to settle medical ques- 
tions, might decide as germane psychic symptomatology in a 
medical question, before even the experts had the evidence 
they were seeking through the Judge's exclusion by 
unjust assumption of superior diagnostic judgment, from 
them. 

The discrediting, by confusing cross examination of 
witnesses in medico-legal cases, who assume an expert 
knowledge of psychiatry which they do not possess, who 
have had none of that clinical experience which is, as 
Esquirol pronounced so long ago, essential to the forming 
of a correct judgment on the subject, by confusing and often 
irrelevant cross examination, hurts the cause of a really 
insane person. This is legitimate in legal cross examina- 
tion, and ought to deter medical men without expert psy- 
chiatrical knowledge, from assuming to know what they do 
not know on this often intricate subject. But egotistical 
"smart Alex's" are in the medical as they are in the legal 
profession, ready to damage a good cause by a display of 
self-conceit, in lieu of knowledge and real skill. Exagger- 
ated egotism may be found in any profession, not alone 
among insanity experts, as ample illustrations confirm among 
lawyers, and as it is sometimes found on the bench. 

But when a medical man possesses real knowledge of 
facts tending to show disease of the brain developing in- 
sanity, he should testify to the facts as facts, being careful 
not to pose as a psychologic expert, and cautious as to the 
assumption of general psychological expert knowledge, un- 
less he possesses the latter knowledge. The circulation of 
the brain's blood with insomnia and psychically disordered 
function, taken in connection with symptoms of mind 
change and perversion, may justify a personal conviction as 
to the mental state of an individual, seen and treated, 
without justifying the assumption of general expertness in 
determining the existence or non-existence of insanity in 
general. 



356 



C. H. Hughes. 



The testimony of Dr. Wiley, in the Thaw trial, as 
his own fact of observation was valuable as to the exist- 
ence of chorea, showing disturbance (instability) of the 
nervous system of Thaw in childhood, and his testimony 
as to Thaw's impulsive moods displayed in the opening 
and closing of a street car window on a certain occasion, 
the family history, etc., were facts which were worth 
something, added to other similar facts throughout Thaw's 
life. They were worth something to an opinion witness in 
making up an estimate of insanity predisposing presump- 
tion of neurotic instability, but the assumption by Dr. 
Wiley of being an authority in psychiatry, was as much a 
mistake, as some of the cross questions of the prosecuting 
attorney were malapropos and damaging to his cause, as 
showing the animus and motive of the prosecution to win, 
whether his cause was just or not, as well as his fear of 
the possible effect of Dr. Wiley's testimony on the jury, 
making it appear necessary to totally destroy the psychic 
influence of the physician's evidence. "As mild a man- 
nered man as ever scuttled a ship or cut a throat" in a 
pirate, would better have become Mr. Jerome in his hand- 
ling of the experts, and better promoted his cause, such for 
example, as the purely neurological, and not at all 
psychological questions asked Wiley, for they had nothing to 
do with mental states, viz: The question as to the 
Kratch- Romberg and Argyll- Robertson signs, etc. They 
pertain to neurology as distinguished from psychiatry, 
though every alienist now-a-days ought to know about 
them. Nevertheless, the older alienists, who were good 
diagnosticians of insanity knew nothing about these 
strictly spinal cord neurodiagnostic tests. As well ask an 
alienist the malapropos question as to what is the virile, 
or genesic or cremasteric reflex, the knee, toe and foot 
reflexes, etc. These are concerned in the diagnosis of 
states of the spinal cord, while insanity is a disease in 
which the brain is chiefly involved, the spinal cord being 
far more often intact than otherwise in mental aberration, 
though spinal and cerebral diseases may coexist as in the 
rare insanity of cerebro-spinal sclerosis. There were, as I 



The Alienist on the Witness Stand. 



357 



have said, great alienists who could clearly diagnosticate 
insanity before this modern symptomatology of the spinal 
cord was discovered, and not so long ago, either. It is not 
far back to Marshall Hall, Brown Sequard, Claude Bernard 
and Sequin and their colleagues nor to Van der Kolk, 
Griessinger, Bucknill, Luke, Ray and others of their day. 

But assumption of overmuch knowledge in a medical 
man is a mistake, and may prove as harmful as too much 
acerbity of temper and vehemence may be to an attorney's 
examination, as was displayed by the tempestuous, bril- 
liant, violent, incisive Boanerges of the prosecution in the 
Thaw case, especially in the earlier days thereof. 

To claim expertness in psychiatry when one is not 
thoroughly informed, recalls the "word or two of advice" 
which Dr. Isaac Ray, in the very first edition of his great 
work on forensic psychiatry, deemed it necessary to give 
medical men summoned to testify as alienist experts in 
court. "Let him beware," this skilled clinician and expert 
in psychiatry said, "hew he suffers the dread of being 
thought ignorant of his profession to draw from him a 
positive and unqualified reply, where a modest doubt would 
better express the extent of his knowledge." 

In this connection, and in relation to the Thaw case, 
Ray's sound injunction to the alienist opinion witness as to 
returning categorical answers, should be heeded whenever 
necessary to make plain, unequivocal and not misleading 
his meaning in answer to the questions of counsel. "He 
must," he says, referring to the expert's answers, "in spite 
of the authoritative demand for a yes or a no, so qualify 
and explain his answers, as to prevent any mistake of 
their meaning, and no dread of amplication should deter 
him from this purpose. Let him bear in mind that he has 
unquestionably a right to express his opinion in his own 
way. He is put upon the stand to answer, not solely such 
questions as the ingenuity of counsel may prompt to fur- 
ther their ends, but to give an opinion on a scientific sub- 
ject for the purpose of promoting the cause of justice." 
And to this it may be added that no class of experts are 

*18€0 Edition (etante) Jurisprudence of Insanity*. 



358 



C. H. Hughes. 



more subjected in our courts to this same sort of haras- 
sing, inappropriate and often insolent questioning by law- 
yers as medical opinion experts. 

To satisfactorily establish even the presumption of in- 
sanity or to indubitably controvert it, the biography of a 
life with its environmental influences has often to be 
brought out. Even those otherwise unaccountable out- 
bursts of psychokinesia or temporary insane displays, in 
some instances termed mania transitoria, kleptomania, 
emotional insanity, or epileptic unconscious automatisms or 
psychic epilepsias and morbid fulminations of passion and 
impulse, often require long antecedent or subsequent his- 
tories to prove or disprove their real morbid nature. Their 
study often requires patient and thorough investigation and 
cautious judgment in the examination of circumstances, 
which to the non-expert mind and even to presiding 
judges, who may consider the true nature of insanity so 
simple always as to be within judicial ken, may seem 
irrelevant and of so little significance as to be fit only 
to be ruled out from the summing up of circumstances and 
symptoms. 

If correct diagnosis of insanity, even of mania transi 
toria and all psychokinesias is like the examination of th 
apparently strong rope or chain or brace that suddenly 
breaks under even ordinary strain, because of the pre 
viously long persisting strain and long wearing, thinning 
rusting or otherwise weakening of the threads or links, re 
quires a knowledge of the life of the rope or chain and the 
influence of the environing elements and strain upon it or 
them to account for how and when the weakness may 
have developed, and to prove that the break was an un- 
avoidable occurence or an unwarranted fact, for which the 
manufacturer of the rope or chain or brace could be held 
responsible because of flaw in manufacture or careless- 
ness, ignorance or design, how much more important it is 
to know all about the life of a brain and mind sup- 
posed to have broken and departed from normal psychic 
integrity? 

The insidious, predisposing, developing and culminating 



The Alienist on the Witness Stand. 



359 



causes of brain break, as well as conditions confirm- 
atory after the fact, should all enter, and be allowed by 
courts to enter into the psychological analysis and expert 
judgment. To establish possible insanity, or to prove 
soundness of mind, one should be unhampered in symptom- 
atic fact or logical resource. 

A physician neurologist and alienist, inquiring into the 
existence previous to an outburst of mania, of a neurotic 
skin disease, an angioneurosis, for instance, or an urticaria, 
would appear exceedingly illogical to a judge like his 
honor on the bench in the Thaw trial, perhaps. His judi- 
cial excellency might even regard such an expert as a lit- 
tle off himself in his mental makeup, or he might, like a 
certain English judge well known to forensic psychiatry, 
think such a physician had better be with his patients. 
But the judiciary has learned much from clinical psychiatry 
and is destined to learn yet more from modern alienism, to 
the advantage and welfare of mankind since that obiter 
dictum . 

But what does the ordinary judge of the criminal court 
now know of the vasomotor neuroses, and of their relation 
and precedence often, to those actual cerebral hyperaemias* 
due to lesion of the vasomotor nervous mechanism of the 
brain, which cause homicidal impulses, vertigos and 
apoplexies? 

Judges who decide peremptorily on the proof or ab- 
sence of proof, or upon the needful elements of a proof or 
disproof in a case of possible mental aberration should con- 
cede more to the needs of psycho- scientific inquiry than 
has been displayed in the Thaw trial concerning the ques- 
tion of insanity. 

The many startling and disastrous outbreak culmina- 
tions of a slowly invading brain disease, prodromal to 
marked insanity, which daily come to our knowledge, like 
the sudden paralysis of heart or brain of precedent ner- 
vous exhaustion cause that astonish the public, have their 
origin usually in long previously developing morbid con- 
ditions, many of which, if timely appreciated and treated 
could be averted or long postponed. 



360 



C. H. Hughes. 



A married man, a thrifty gardener, goes to bed and 
sleeps calmly, but is awakened in the early morning, his 
wife standing over him and about to cut his throat with a 
butcher knife brought from the kitchen, where she has 
burned the hoarded savings of many years of industry. A 
few days and she is dead of cerebral hemorrhage, the result 
of a far back atheroma and hyperaemia ending in arteriole 
rupture and sanguine extravasation into the ventricles of 
the brain, and yet she had had no previous inquiry into, 
or treatment of, her predisposing long developing vascular 
disease of the brain that caused these insane impulses. 
Conditions that develop sudden mortal brain or heart dis- 
eases are often of slow development as are the predispos- 
ing conditions of sudden heart paralysis. 

The autopsy in this case of insanity explained all, as 
it has done in regard to other insane persons similarly 
afflicted, but executed for irresponsible homicide. Legal 
ruling out of testimony necessary to form an expert judg- 
ment on a question of mental aberration, though not other- 
wise germane to the cause before the court, is a judicial 
crime against a possible helpless creature who should have 
the court's strongest help, and is therefore a crime against 
the dictates of humanity and justice. 

"In this country the course usually adopted for elicit- 
ing the opinion of the expert, is to ask him if he has 
heard the evidence, and if he has, and supposing it to be 
true, what is his opinion respecting the mental condition of 
the party."* 

The medical experts "are not," continues Dr. Ray, 
quoting from a decision of the court in Commonwealth vs. 
Rogers, 7 Metcalf, 500, "to judge of the credit of witnesses 
or of the truth of the facts thus testified by others. It is 
for the jury to decide whether such facts are satisfactorily 
proved. In other courts the hypothetical case is substituted 
for the submission of testimony and assuming the stale- 
ments set forth in the hypothetical case, which is pre- 
sumed to be built upon the evidence, to be true, he gives 



•I. Ray, Medical Jurisprudence of Insanity, chapter xxix., subject, "Duties 
of Medical Witnesses." 



The Alienist on the Witness Stand. 



361 



his opinion, and the jury decides whether the hypothesis 
is true or not and determines what credibility is to be 
given to the expert witness/' 

But it is common now for attorneys to object to the 
statement of the hypothetical case, if they think the as- 
sumed facts stated are not in the evidence, and the writer 
has often seen hypothetical cases of supposed insanity 
amended and patched and shorn under such objection from 
the opposing counsel. In a recent will case in Illinois one 
hypothesis was submitted after a day or two of legal con- 
tentions, to the experts of either side, the presiding judge 
assisting in its construction. 

But in the Thaw case how variant and peculiar the 
judge's rulings. The defense must first lay its foundation 
in the testimony of its experts, who, instead of this re- 
stricted ruling should be entitled to all the evidence to be 
had from both prosecution and defense, in addition to their 
own personal examination, in order to form a complete 
opinion. The value of the expert opinion to the jury is in 
the effect the whole testimony added to the special expert 
examination, which yields him certain direct personal evi- 
dence, has upon the mind of the expert specially familiar 
by long study with the intricate question of insanity. 

Under the presiding judge's ruling in the Thaw case 
the defense was forced in the beginning to put its experts 
on the stand without all the evidence, without all the facts 
available in the prosecution's testimony and in the con- 
duct of the prisoner himself during the trial, facts which 
they should be entitled to have, if they want them, for in- 
sanity may be established by reasoning from evidence both 
a posteriori as well as a priori, and at the time when and 
whence the date of the accusation or contention begins. 
The supposed insane man's conduct and speech during the 
trial, if he be living, may be valuable symptoms for or 
against a hypothesis of mental disease. 

With the correct dictum of Ray before us we should 
always insist upon having all available facts in the tes- 
timony, before giving a final and irrevocable opinion, for it 
is a fact that must never be forgotten, as this wise and 



362 



C. H. Hughes. 



learned alienist expert author states at the conclusion of 
one of his best chapters, "that the phenomena of insanity 
do not lie on the surface, any more than those of othei^ 
diseases, but oftentimes can be discovered only by means 
of patient, close examination*." 

Being lead to give direct categorical answers in the 
Thaw trial when they were not necessary to the truth, 
some of the experts placed themselves in an incorrect 
position as to the lawful source of the foundation for their 
opinion. An expert who had formed his opinion from per- 
sonal examination of act, speech, etc., to the question, 
"Your opinion doctor is made up from all you have seen and 
heard in this case?" Answer Yes. Whereas some of them 
might properly say their opinion was made up from personal 
examination and interrogation of the prisoner "and fortified, 
but not changed by facts not yet in evidence, of which I 
have become personally cognizant and which I now detail 
to you under oath from my personal experience and obser- 
vation." 

And here comes in the very manifest injustice. to the 
accused. The medical experts are required to go on the 
stand in the beginning, instead of at the close of the 
testimony and give an expert opinion "to lay a foundation" 
as the judge ruled; with only a part of the facts before them 
based upon a necessarily lame hypothetical case and their 
personal examination, whereas personal medical examination 
should go in as direct testimony whether given by an 
assumed psychological expert or by a plain general prac- 
titioner. 

An expert in psychiatry, who has never seen a given case 
of possible insanity, might often form a better conclusion 
from a completed symptomatic biography of an individual 
described through a number of years or months or days by 
medical men and laymen, with a full record of the life, 
character or characteristics of the accused for comparison, 
than by a single or even two or three personal examinations 
without the life history. For "unlike the ordinary witness 
who relates only what comes within cognizance of his own 

♦Conclusion of Section II Partial Intellectual Mania. 



The Alienist on the Witness Stand. 



363 



senses, the expert testifies respecting the inferences that 
may be drawn from the facts related by others" (Ray's 
Medical Jurisprudence of Insanity, subject: Duties of 
Medical Witnesses) "in addition to any personal examination 
he may have opportunity to make." How strange then that 
medical experts should be expected to give an expert 
opinion, in any case, without being first given an oppor- 
tunity to consider all of the facts? 

A medical witness (Dr. John T. Demar, of Killaning, 
Pa.) was put on the stand by the defense to show the 
mental condition of John Ross, a cousin of Harry Thaw. 
The court sustained the prosecutor's objection and the wit- 
ness was excused. Now neuropathic defect in collateral 
line of blood and brain is valuable in sustaining an hy- 
pothesis of hereditary mental instability. 

In making up an expert judgment on a question of 
insanity, every collateral stream or ebullition or ancestral 
possible fountain of psychopathic or allied neuropathic taint 
is germane to the subject of a probable insane latent taint 
predisposing to an outbreak of positive insanity under cer- 
tain exciting influences. It is proper to ascertain and weigh 
all of the organic predisposing aptitudes in the family tree 
to account for and confirm the verity of the present 
patent facts, and fence against the supposition of simulation, 
in making up the judgment. 

The early biased attitude of Presiding Justice Fitzgerald 
in this and many other instances where the objections of 
District Attorney Jerome were almost invariably sustained 
against the plea of insanity, would suggest the summoning 
of an amicus curiae alienist expert, who might help the 
cause of justice and humanity in such trials. Expert 
observers and judges of insanity know that hereditary 
transmission of neuropathic and psychopathic taints can be 
found either in positive and readily recognized mental 
aberration, or in neuropathic or psychoneuropathic instability 
of nerve center element and tendencies to morbid psycho- 
kinesias out of harmony with the normal, psychic neurone 
center organization and environment. "The parents have 
eaten sour grapes and the children's teeth are set on edge," 



364 



C. H. Hughes. 



is a homely suggestion from holy writ philosophy as trite 
as the saying, "as the twig is bent the tree is inclined" — 
plain and suggestive enough for the understanding of the 
attorney or judge non- expert in morbid psychology. As 
well expect "figs of thistles or grapes of thorns" as to 
look for great, well balanced stability of mind, in the 
germinally weakened psychoneurotic individual at the time 
of highest mental maturity and fruition, when he has been 
sent into the world by a congenitally neuropathic fate he 
has had no part in predetermining. 

To expect a weak tree, weak from unhealthy seed, 
improper soil and untrained growth to withstand the 
environing storms and stress like inherently stronger trees 
is not reasonable even to the mind of an arboriculturist. 
Nor does an alienist expect more of an inherently weakened 
and unprotected and untrained neuromental organism at matur- 
ity. A psychoneurotic organism damaged and neuropathi- 
cally unstable from the ovum, maybe nourished improperly 
and badly environed for the promotion of brain stability 
during all its way from the cradle and kindergarten school 
and other surroundings, to a precocious and psychically 
unstable and explosive manhood. For this way lies psycho- 
pathic organic propensity, paranoid evolution and paranoiac 
culmination. 

The New York knowledge of a right and wrong legal 
test of insanity, as expounded in the Thaw case, contravenes 
true psychopathic science in many of its most important 
features, as in forms of hysteric insanity, certain phases of 
psychic epileptic insanity, and in the morbid psychokinesias, 
and psychlampsias generally. Homicidal maniacs do not 
all have delusions on the subject of killing. These resist- 
less impulsions, with knowledge of the wrong, are described 
in the literature of psychiatry and have come within the 
writers personal observation. Morbid impulsions are far 
from being derived from this sort of knowledge, and it is 
as absurd to hold the brain diseased psychokinesiac or 
psychlampsic responsible for a disease impelled killing as it 
would be to hold an epileptic guilty of his spasms. 

But the blunders of lawmakers, confidently acting without 



The Alienist on the Witness Stand. 



365 



warrant of practical knowledge within the domain of psycho- 
pathy, if not the result of misleading, inadequately experi- 
enced medical counsel, are often the result of unpardonable 
exaggerated egotism, lacking the mantle of morbidity in its 
possessors, to extenuate their fatal errors of conclusion, 
formulated into wrong statutory enactment; the effect of 
which may be and often is, judicial murder of the innocent 
mentally disease dominated, without normal minds and wills 
to control and keep them within the line of the law's 
inhibition. Insanity is often more than a lesion of the 
powers of perception of right and wrong. 

Insanity is often more and often less than a marked lesion 
of the intellectual perceptions of right and wrong. The intel- 
lect often largely escapes very apparent involvement in 
disorder, though the intellect is generally, in a manner, 
insidiously undermined in insanity, especially when this 
peculiar disease attacks chiefly and dominates the emotions, 
the propensities, the passions or the will, as in the insani- 
ties of the affective life, in melancholia, hypochondria, folie 
raisonante, etc. 

The building of the brain, which the mind inhabits, 
may be partly . damaged or totally destroyed in insanity, 
as the house may be in which our bodies reside, and 
the mind acts differently as the body does, according 
to the perfections or imperfections of its tenement. The 
tenant and the tenement in both instances are mutually 
dependent. They each generally reflect the condition of 
the other, for insanity is a psychic disease of the brain and 
may appear in various forms and degrees according to the 
extent and location of the brain's involvement in disease. 
Hence the absurdity of limiting insanity to that kind of 
cerebropsychic disease that destroys the knowledge of right 
and wrong excluding the brain-diseased impulse and the 
brain-damaged inability to resist the impulse of disease 
even though conscious of its wrong. 

Another violence to psychopathic science in this remark- 
able trial was in the limiting of the diagnosis of the 
defense's medical witnesses to insanity up to the date of 
the homicide and not allowing them to go further with the 



366 



C. H. Hughes. 



diagnosis and then summoning a commission of inquiry of 
two layman and one medical man to decide as to insanity 
or sanity after the fact. If insanity is a disease, it is a 
medical question, to be decided by medical methods and by 
medical men. It would be almost as absurd to arrest a 
surgeon in a saving operation, turn his case over to lay 
nurses and tell him he had gone far enough, as to stop the 
physicians at a certain point and turn the case over to a 
commissio de lunatico inquirendo, composed of a two -thirds 
majority of non-medical men, and say, as was in effect said 
in the Thaw case, "the medical expert testimony has gone 
far enough for our purpose." With their idea of the first part 
of the case we will now decide the other end of the man's 
mental status, with expert laymen and a doctor to look on. 
First the medical view up to the point of killing, then the 
layman's view of the mind of the man now. If the medical 
men of New York have the influence they should have in 
such matters they should see to it that this insane commis- 
sion law is changed so that only medical men shall be on 
the states' lunacy commission. The rights of the insane, 
the rights of the community and due respect for the medical 
profession demand that only a medical commission should 
decide a medical question. 

To be Continued. 



PSYCHOLOGICAL STUDIES OF MAN'S MORAL 
EVOLUTION.* 

THE CREEPING SERPENT IN OUR GARDEN OF EDEN. 
By ALBERT S. ASHMEAD, M. D., 

NEW YORK. 

THE entire Semitic race, according to Hebrew tradition, 
sprung from Shem, one of the three sons of Noah, 
and from Ham and Japhet came the remainder of the hu- 
man population. Another tradition says that earlier, the 
sons of Adam came to the plain of Shena or Babylon, and 
there burnt bricks and built the Tower of Babel. Babylon, 
it is thought, was the original home of the Semitic race, 
and that from the valley of the Tigris and Euphrates, one 
Semitic tribe after another, Assyrians, Phoenicians, the 
Aramaeans, Hebrews and Syrians abandoned their birthplace, 
while the Arabs, the largest branch, always stayed there. 
Archaeologists believe that the original first home of the Sem- 
itics was in some other place. The earliest Mesopotamic 
ruins show that cities flourished there 6,000 years ago, 
which were not Semitic* They were besieged, doubtless, 
by Semites, whose inscriptions show that it occurred 4000 
B. C. These inscriptions show writing's by means of 
wedges, closely resembling the Hebrew. The Semites were 
the besiegers who adopted the earlier settler's civilization 
and religion. Accepted chronology by Biblical scholars 
shows that the world was created 4004 B. C. This is 
about the date when the Semites appeared on this part of 
the earth. 

The earliest character in Semitic history is Sar- 



*Continued from May. 1907. 

( 367 ) 



368 



Albert S. Ashmead. 



gon, 3800 B. C. Semitic tablets there are still earlier 
showing that Semites were there still earlier many cen- 
turies. Moses appeared 2500 years later than Sargon. 
These earliest Semites were savages, like American In- 
dians. These earliest Semites adopted the civilization 
which they found and learned to build houses of adobe like 
of Mayan civilization. They built them of mud- bricks. 
The housewife's oven 6000 years ago was called, as mod- 
ern Arabs still call it, "tenmtr." They irrigated plains, 
dug wells, etc. Public baths were in vogue 6000 years 
ago. They worked gold and bronze, engraved and sculp- 
tured; made statues, etc. They were agriculturists, raised 
crops of barley, sesame and cotton. The potter's art was 
known. They understood weaving 6000 years ago, like 
Mayans. They knew saltpetre. They were wanderers 
over the face of the earth, like Jews of today. They lived 
by trade rather than by labor. These qualities of Jews 
and Arabs were the same then as they are today; in 6000 
years they wandered from barbarism into the valley of the 
Tigris and Euphrates. Nobody knows where they came 
from. 

In the ancient language of the Hindoos, the Sanscrit, 
which is now a dead language for 2200 years, the magnet 
was called "the precious stone beloved of iron." The Tal- 
mud speaks of it as "the stone of attraction," and it is 
alluded to in early Hebrew prayers as Kalamitah, the 
same name as is given to it by the Greeks; from the reed 
upon which the compass floats on the water in a cup or 
shell. The Phoenicians knew the magnet. At the prow of 
their vessels (they were great navigators) stood the figure 
of a woman (Astarte) holding a cross in one hand and 
pointing the way with the other; the cross represented the 
compass, which was a magnetized needle, floating in water 
crosswise upon a piece of reed or wood. The cross thus 
became the coat of arms of the Phoenicians. The magnet 
was called the "stone of Hercules". Hercules was the pa- 
tron divinity of the Phoenicians. The Phoenicians colo- 
nized on the shores of the Mediterranean, according to 
Plato. From the Phoenicians the magnet passed to the 



Mans Moral Evolution. 



369 



Hindoos, and from these to the Chinese. In the year 2700 
B. C., the Emperor Wang-ti placed a magnetic figure with 
an extended arm (like the Phoenicians used) on the front 
of carriages, the arm always turning and pointing to the 
south, which the Chinese regarded as the principal pole. 
(Goodrich's Columbus), v All nations have connected the 
compass in the earliest knowledge of it, with the load- 
stone. Wherever it was used; it is associated with regions 
where Heraclean myths prevailed. (Lapis Heracleus). 
"Lodemanage," in Skinner's Etymology, is the word for 
the price paid to a pilot. Whether the famous and after- 
wards deified Mariner (Hercules) had a compass or not, we 
can hardly regard the association of his name with so 
many monuments as accidental. 

The needle of the Hercules cup, as the compass was 
called, was an "oracle" affecting vividly the minds of all 
people as pointing to the north. It thus would be symbol- 
ized in their works of art. Greek mythology tells us that 
when Hercules sailed to the island of Eythia, in the At- 
lantic, he borrowed the cup of Helios, with which he was 
accustomed to sail every night. This magnetic cup was 
used for night sailing. A sea shell was used to hold the 
water upon which the needle floated. 

Upon ancient coins of Tyre a sea shell is represented, 
also two pillars of Hercules, supposed to be placed at the 
mouth of the Mediterranean, and the tree of life or 
knowledge with the serpent twined around it, connected as 
in Genesis. These were Phoenician coins. In Maya coun- 
tries of Central America upon the reverse side of coins, 
there is represented a serpent coiled around a fruit tree. 
The first God of Mayans (Legends of the Phoenicians) 
Ouranus, devised a person contriving stones, that moved as 
having life, which was supposed to fall from heaven. These 
were probably load stones, from which was devised the 
mariner's compass. Mayan priests foretell future events 
by a stick in a bowl of water, whose point turns according 
to their will. This is incomprehensible, unless it is loaded 
or magnetized. 'The reclining statue of Chac-Mol, in Mayan 
countries, holds a bowl on its breast. Divination was 



370 Albert S. Ashmead. 



Etruscan. The Etruscans set their temple of worship, as 
did Egyptians, and ancient Mexicans and Mound Builders of 
America, squarely with the points of the compass. The 
Romans and Persians (Fire-worshippers and workers in 
iron-ore) called the line of axis of the globe Cardo, and it 
was to Cardo the needle pointed. Now V'Cardo" was the 
name of the mountain on which the human race took refuge 
from the deluge — the primitive geographic point for the coun- 
tries which were the "cradle of the human race." (Urqu- 
hart's "Pillars of Hercules.")- From this comes our word, 
"Cardinal," as the Cardinal points. 

The compass, or magnetic needle or Hercules pillars, 
were objects of worship in earliest Phoenician and Mayan 
times. They represented power over the action of man. 
Mr. Teoberto Maler has written me from Ticul, Yucatan, 
as follows: "Without any doubt the snake, principally the 
snake head (sometimes treated naturally, sometimes 
in a phantastic manner, with infinite variety) forms 
the principal element of decoration in Maya archi- 
tecture. This alone would not be sufficient to estab- 
lish a relationship ( Verwandtschaft) with the architecture 
of the Naga tribes (dasyu), pre-buddhistic snake and tree 
worshippers; if it were not for the fact that Maya archi- 
tecture also has some very remarkable resemblances with 
ancient Hindoostan (pre-Ayrian) attributable to the Dasyu 
(Naga, etc., Sanscrit), perhaps to be counted with the 
Georgian, Hittite, Thibetian race) and even perhaps to the 
Dravidean style (Telinga, etc., probably of Turanian, Mon- 
golian, Turkish origin.) For instance, the Maya triangular 
arch is the same as the arch in ancient times throughout 
Hindostan; and the triangular decoration of the west facade 
of the Eastern palace of "Las Monjas" at Uxmal recalls 
ancient Hindu wooden structures in use, for Instance in 
Kashmir bridges, till our days. 

It would therefore be interesting to compare the Maya 
language with that of the Naga tribes, and also with the 
Turanian languages of the Dravida. 

The word Naga is applied in Hindu mythology to a 
deified serpent. The Naga tribe went naked. Dasyu 



Man's Moral Evolution. 



371 



means hairy. The Hittites were Hamites. Hamitic art 
flourished 1000 B. C, in Asia Minor and Syria: rock 
sculptures and ruins of sanctuaries. It was Oriental, like 
that of Mesopotamia and Persia, and very similar to Phoe- 
nician or Mayan. 

Sanscrit applies to the language and not to the script. 
Sanscrit is one of the oldest of languages, while its script, 
or vehicle, or its "alphabet," Deva-Nagari, is of more 
modern origin. Deva means "bright," as applied to the 
power of a God. The Nagari "alphabets" of India are an 
important group of indigenous vernacular "alphabets." 
This was long anterior to the alpha-beta method of 
expressing thought. A language, the word of mouth or 
the tongue of a people, then was recorded through its 
vehicle, the Naga, the serpent, or "alphabet." When the 
serpent "spoke," it was meant that it was written. 

Dravida was a geographical situation of Southern 
India. Dravidic means one belonging to the pre-Aryan 
race and stock of the Deccan. 

Fifty million people speak the Dravidic tongue. They 
are non- Aryans; no one knows where they belong. Some 
think them Ural-Altaic. 

Mayans did not believe that the souls of the dead all 
went to one place. Three different places were provided 
for them, according to the manner of their death. Men 
killed in battle, as well as prisoners immolated on the sac- 
rificial stone, and women who had died in childbirth en- 
tered heaven, the house of the Sun; and it was the duty 
of the former to accompany the luminary from its rising to 
the zenith with merry dances, while the latter received it 
at its Zenith and escorted it down to its setting. The 
multitude of those who died in their beds of various dis- 
eases, entered into everlasting rest, into Mietlan, the king- 
dom of darkness and shadows, which was supposed to be 
situated deep down in the earth and in the North, and from 
which there was no return or escape. But those who had 
encountered death through Tlaloc, the God of the Moun- 
tains, of rain and storms, entered into the Kingdom of that 
God, which was situated at the top of a mountain, a region 



372 



Albert S. Ashmead. 



of everlasting coolness, where everything: grew and sprouted, 
where fruits of all kinds existed in abundance, a kind of 
earthly paradise. These were not burned like other dead, 
but were buried in the ground (interred.) But those con- 
sidered as killed by Tlaloc were not only the victims of 
thunderbolts and the drowned, but also those who had died 
of gouty, rheumatic or feverish diseases, and those who had 
succumbed to infectious diseases, etc. 

They believed in a Garden of Eden. To the rain-god on 
whose favorable or adverse disposition so much depends in 
the life of the poor natives, toiling on the glebe, and living 
on the products of the fields, a great number of holidays 
were consecrated in the course of time. He was plied with 
sacrifices to obtain from him fair weather for the crops. 
Besides that, every eighth year, in the Autumn on a day 
specially appointed every time, a festival was celebrated 
under the names atamalqualiztli ("the eating of water- 
fritters;") ixnextinaya ("where one gets means;") atecocol- 
tinaya ("where the shell-horn is blown") and which 
centered also in Tlaloc, the rain-god. During that feast a 
severe fasting was kept up; only water-cracknel was eaten, 
prepared with Maize mixed with water, to which no salt 
nor capsicum was added; the Maize was not previously 
softened by boiling it with quick-lime. The people said 
that by that feast they meant to give rest to the victuals, 
that is the products of the fields which had been harried 
during the last eight years, by being treated with salt, 
with pungent pepper, with soda-salt earth, and by being 
cooked with quick-lime, and that they would thus gain new 
life. 

It was quite natural that Tlaloc, the rain-god, should 
be the centre of such a feast. He appeared, but not alone; 
with him all the Gods of the Mayas, that is persons in the 
garb of divinities, performed a dance. There appeared 
besides, various characters more or less closely related to 
Tlaloc. The most remarkable part in this festivity was 
played by certain actors (or shall we say artists?) who, it 
would seem belonged to a peculiar people, or at least came 
from a peculiar village, as they went by the special name 



Man's Moral Evolution. 



373 



of Mecate ca ("those from the stag-land.") These men 
seized with their teeth snakes and other reptiles preserved 
in a vase full of water, danced about with them in their 
mouth, and finally swallowed them alive. This Mayan 
feast, offers a curious parallel to the celebrated snake-dance 
of the Hopi or Moqui Indians of Arizona. 

The woiship of the snake was natural to all early 
Man, especially in his naked and hairy days, as it was a 
survival of the reptilian age. The worship of the turtle 
of Hawaii and Japan, belongs to the same idea. Religion 
and these reptiles were inseparably connected, as was the 
crocodile in Egypt. The snake represented power. In our 
own Southwest in the Navajos Indian regions, among the 
Snake Indians, snake dances are still in vogue, which are 
religious observances. Thus the eating of the snakes in 
the religious ceremonials of Mayans, was in strict keeping 
with the religious observances handed down probably to 
the Pueblos, Navajos and Zunis. All pictographs in Ancient 
America, on rock and sand (earth) were really chants to 
the deities. They implied voices, or speech, prayers, etc. 
These were very elaborate, and fashioned with exceeding 
care and ceremony, immediately preceding the observance 
of the specific religious rites. Some were curative or 
"betterment" ceremonials of priests. "Prayer Meal" 
(Earth) was used on the "Pathway of Life," symbolical 
of mortal things. 

Sacramental things were represented on the four cardinal 
points of the compass, North, South, East and West 
walls of something. The Navajos imitated these ceremonies 
from the Pueblos. Skin paintings among the Navajos and 
Pueblos, are supposed to be spiritually shadowed, or breathed 
upon by the gods or god animals they represent, the snake 
was one of these last. The paint substance, therefore, is in 
a way incarnate and at the end of the ceremony, the 
animal must be killed and disposed of as dead if evil, eaten 
as medicine if good. This is what Mayans do with the 
snakes, which they use in the religious ceremonies. The 
serpent mound of Ohio, represents religious consecration of 
the dead to the god animal or reptile. Prof. W. H. Dall 



374 



Albert S. Ashmead. 



n "Mask , labrets, and certain aboriginal customs, says: 
"The original population of America is too distant to form 
the subject of discussion. There can be no doubt that 
America was populated in some way by people of an 
extremely low grade of culture, at a period even geologically 
remote." Prof. Dall calls attention to the singular form of 
carving, representing a figure with the tongue hanging out, 
and usually communicating, with a frog, otter, bird, snake, 
or fish, observed on the Northwest coast of Oregon to 
Prince William Sound, and also in Mexico and Nicaragua, 
details of art related to religious and mythological ideas. 
The prominent Tlaloc nose (God of rain) and certain 
Central American figures, of which the supposed elephant 
proboscis is but one form and the bird bill (thunder bird) 
of the Northwest coast, are but different methods of 
representing the same idea, and one is undoubtedly the 
outgrowth of the other. These are religious. 

The general tendency of the more recent opinions in 
regard to the peopling of this hemisphere is that it was 
partly from the Atlantic side, and they look to Europe as 
the original source of American man. Dr. Brinton in his 
"Races and Peoples" says: "These knotty points 1 treat 
in another course- of lectures, where I marshal sufficient 
arguments, I think, to show satisfactorily, that America 
was peopled during if not before the great ice age, that its 
first settlers probably came from Europe by way of a land 
connection, which once existed over the Northern Atlantic. 
Dr. Horatio Hale is inclined to substantially the same view. 
It is evident that this idea of a migration on the Atlantic 
side reached by linguists after a study of a large amount 
of data, is to be attributed largely to the unsatisfactory 
result obtained in trying to trace out the links in any other 
direction. 

Dr. Brinton has arranged his linguistic groups of 
American races on this basis, with two Atlantic sources. 
The Athabascan and the Shoshone, sent out colonies, 
which settled on the Pacific. 

Virchow showed that skulls from Northern Vancouver's 
Island revealed an unmistakable analogy to those of Southern 



Man's Moral Evolution. 



375 



California. Other physical similarities marking the Pacific 
Indians contrast them well with those East of the Moun- 
tains. Higher civilization was contained in the Mexican 
group which Nadaillac thinks points to Pacific origin of the 
Americans. 

The linguistic relation between civilized Mexico and 
Central America and the Mound- builders is not sustained. 

Time is an element in the development of languages, 
and for the diversity of languages. In pre-Columbian 
America, at the time of the acme of Mayan civilization, 
when the Tree and the Serpent were worshipped, or repre- 
sented something still religiously interesting or important, 
and considering only the pictographs, and petroglyphs, or 
religious language an expression of evolved intelligence 
from nescience, or blank animal ignorance, the time required 
to morally differentiate the numerous stocks and dialects 
of America must have been very great. Few students of 
American architecture, and archaeology, entertain any longer 
a doubt that the monuments of Mexico and Central America, 
are attributable to direct ancestors of the people found occupy- 
ing the country at the time of the Spanish conquest. Brinton 
says: "We cannot identify the builders of the ruined 
cities of Palengue in Tobasco, and Copan in Honduras, 
with the ancestors of any known tribe, but the archaeology 
evidence is conclusive that whoever they were they belonged 
to this Stock, the Maya, and spoke one of its dialects." 
The ruined structures of Copan, Palengue, T'Ho and other 
cities were deserted, and covered with primitive forest 
apparently; but others not inferior to them, Uxmal, Chichen, 
Itza and Peten were the centres of dense population, proving 
that the builders of both were related. Marquis de 
Nadaillac, who embraces the Mayas, the Aztecs and other 
Central American Stocks in the Nahautl race says: "It is 
to various branches of the conquering race, that we owe 
the ruined monuments still scattered over Mexico, Yucatan, 
Honduras, Guatemala and Nicaragua, and found as far as 
the Isthmus of Tehuantepec, (L' Amerique Pre-historique.) 
The Ancient Mexican called the disease syphilis Nanuhuatl. 
McLean claimed that this word meant "Understanding 



376 



Albert S. Ashmead. 



Serpent." Bruhl, however, ridiculed this interpretation of 
the word, stating that it meant "Syphilis," and nothing 
else. I think myself that McLean was right. This disease 
Syphilis is strangely represented on potteries of Ancient 
America, by a serpent wound around the neck of the patient, 
while its head is shown in the act of eating the special 
parts of the body usually attacked by the disease. This 
representation means "Syphilis," and has something to do, 
is the idea of those ancient peoples, with generation 
{creation) of human beings. It was the disease of "Nobles," 
representative of power or powerful persons. 

The ruined Pueblos of New Mexico and Arizona are 
to-day attributed to the ancestors of the sedentary tribes 
of these sections. It is also conceded that the cave- and 
cliff-dwellers, "Snake" and "Eagle" Indians, are attribu- 
table to the ancestors of the present Pueblo tribes, the 
Mayans. 

, The "Pillars of Hercules," the "Tree and the Serpent," 
are nothing but the history records of religious pilgrimages 
to a better world, an evolution of mankind so to speak. 
These are found on Mayan hieroglyphics and on coins, also 
represented together. The tree and the serpent, by itself 
represents the birth of a new intelligence in mankind, when 
religion was evolving in the human brain. Is it wonderful 
then, that such a picture, a whole alphabet, a language in 
itself, should survive from the distant past? The idea 
whether of good or evil, applied to it is relative, from our 
later historical standpoint, by the religious complexity of 
language of to-day. At that early period however of mans' 
civilized evolution, it may have meant nothing more than 
a plain record of fact. The creeping serpent in a Garden 
of Eden, in all probability represented on'y the birth of a 
new Spirit, that of religious understanding-, and was a 
symbol of language at that time having some reference to 
Serpent Worship, (See note.) 

Note: — Sir Henry Rawlinson says: "So great is the analogy 
between the first principles of the science of writing, as it appears to 
have been pursued in Chaldea, and as we can actually trace its progress 
in Egypt, that we can hardly hesitate to assign the original invention 
to a period before the Hamitic race had broken up and divided." 



Man's Moral Evolution. 



377 



Humboldt says: "According to the views which, since Cham- 
pollions' great discovery, have been gradually adopted regarding the 
earlier conditions of the development of alphabetical writing, the 
Phoenician as well as the Semitic Characters are to be regarded as a 
phonetic alphabet that has originated from pictorial writing; as one 
in which the ideal signification of the symbols is wholly disregarded, 
and the characters are regarded as mere signs for sounds." {Cosmos, 
Vol. II.) 

Sir William Drummond in his Origines says: that "hieroglyphical 
writing was in use among the Tsabaists in the first ages after the flood, 
when Tsabaism (planet-worship) was the religion of almost every 
country that was yet inhabited." 

Sabaism, was the doctrine of a sect, in Persia and Chaldea, who 
recognized the Unity of God, but worshipped intelligences supposed 
i to reside in the heavenly bodies; the common people extended the 
i worship to the heavenly bodies themselves. Tsabian or Tsabaist, was 
a member of a polytheistic ancient Haran Sect of Mesopotamia; 
supposed to be referred to by Mohammed in the Koran. 

A Sabian or Mandoean was a member of an ancient sect of Gnos- 
tics still existing in Babylon, who combined Judaism, Mohammedism 
and Christianity with the ancient Babylonian worship. 

But my pot of protest is ever bubbling and must again 
erupt. Much that I have written here is not quite along: 
the line of my usual thought — perhaps not at all. For it 
is the moral attitude of God towards mankind and all the 
face of the earth that has occupied my contemplations 
which, feeble as they may be, are my highest and best 
employment. 

The sufferings, the happiness, the temporary comforts of 
I all the classes and individuals of the lower orders of animate 
I life are continually present in all my protests against the 
I organized cruelty of Nature and Nature's God, against man 
and the children of men, from their cradles to their graves. 
J Their miseries and agonies form the background of sympa- 
thetic color for the picture ever before me of man's un- 
happy state, subject to the microscopic meannesses, the 
! cataclysmic catastrophies, the capricious cruelties with 
| which Nature and Nature's God pursues his steps. Yes, 
even his helpless, child-like, childish form in infancy is 
not able to appeal to Nature's heart. 

I cannot justify the doing of evil that good may come 
jof it. It is not necessary for Omnipotence to do thus. To 
j excuse Him is to accuse Him. Evolution is a merciless 
Imill ever supplied with grist. 

(To be continued.) 



EROTISM (NORMAL AND MORBID) AND THE 
UNWRITTEN LAW IN OUR COURTS.* 



A MEDICO-LEGAL PLEA. 



By CHAS. H. HUGHES, M. D., 
St. Louis. 




D., a wealthy young St. Louisan, who in a fit of j 
suspicious anger and jealousy, shot his wife, he having 



said at the time she was faithless and the child was not 
his, relied upon his money to free him from the conse- 
quences of his crime, when he surrendered at the nearest I 
police station, saying: that the deed was an accident and 
his money would free him. He tried the unwritten law 
but his counsel did not plead it. He pleaded paranoia, and 
in the final trial epileptic paranoia, but he was convicted 
and executed. 

Belief in the infidelity of his wife did not exist in his 
mind save in moments of inebriate passion, under the 
asserted influence of his paramour and his child was not 
proven to be nor reasonably supposed to be illigitimate. 
The unwritten law would not have been considered in this 
case had there been a foundation in infidelity because 
those insanoid juries who consider and apply the summary 
penalty of death to men who violate the sanctity of the 
home are not disposed to censure or punish the female 
guardian of the home's purity. Retribution sauce that is 



♦Concluded from May. 1907. 

( 378 ) 



The Unwritten Law in Our Courts. 



379 



by them esteemed to be appropriate for the gander is not 
proper for the often alluring goose. This is the law their 
emotional minds make above the law of the statutes. The 
detonation of a gun and a woman in the case unbalances 
their nervous system and they are deluded with that won- 
derful lawyer's plea for the preservation of the sanctity of 
the home which may have no sacred virtue in it. The 
virtuous sanctity depending upon its occupants and the 
shooter himself may be far from a paragon of virtue. 

A matrimonially mismated man in Denver whose wife 
got an order of separation with maintenance and whose 
husband defaulted in payment, because of being out of a 
job, when he got his last jail sentence, tried to explain 
why he could not pay, but concluded nothing could be 
done with a judge when a woman is around crying. There 
is some truth in this remark applied to a greater cause. 
When a woman starts in on the "briny line," as one of 
Judge Baldwin's characters expressed it, she makes a 
strong argument with a man, even though it has no logic 
with it. 

A man in Shreveport, La., Lee Brock, after resenting 
the cursing of a lady (Mrs. Kelley) by the killing of a 
man (L. A. Byckham) was promptly acquitted and mar- 
ried the girl in the court room, the trial judge performing 
the ceremony and the jurymen being the witnesses, fifteen 
minutes after this acquittal. Chivalry steps high and life 
is cheap there. When the bloody "lips of the boy in a 
love kiss unite with the lips of the maid whom his bosom 
holds dear" over the bier of one whom he has just killed 
because of an oath directed to the .woman he loves, love 
must be callous that can bask in the warm blood of the 
newly slain.* 

^Acquitted of Murder, Man Weds in Court. 
Mrs. Hattie Kelley Weds Louisianan Who Resented Insult Offered Her. 

Shbeyeport, La., March ]3, 1907.— At midnight last night in the courtroom, 
where he had five minutes before been declared not guilty of murder, Lee Brock 
was married to Mrs. Hattie Kelley, the woman in defense of whose reputation he 
did the killing, which caused the trial. The jurymen who had acquitted him 
were the witnesses, and the trial judge performed the ceremony. Brock shot L. A. 
Byckham last summer, alleging that he cursed Mrs. Kelley. 



380 



Charles H. Hughes. 



We are disposed to question the mental as well as the 
legal equipoise and soundness of judgment of a judge 
sitting on a bench created by the law, to secure the ad- 
ministration of law, who approves such a verdict against 
the law as in this case. Such jurists and juries are out of 
harmony with the normal and legal demands of their voca- 
tions. Their psychic neurones need adjustment in con- 
formity with the law respecting and law enforcing spirit of 
the majority of the American people who wish to see law 
supreme in the land and its majesty revered and main- 
tained. 

A young girl in St. Louis charges a policeman with 
offering to kiss her. The policeman proves an alibi and 
averts dismissal from the force and a possible unwritten 
law tragedy. 

Paul Thieman, editorial writer for the Denver Post says: 
M J recall a case, years ago, in which a simple sort of 
man was goaded by his virago wife to kill a distinguished 
physician for having taken advantage of her. . . . 
The man had no evidence of it except her story, but, after 
being- tortured with three months of her taunts of cowardice, 
shot the physician to death. . . . The woman was a 
liar. . . . But owing to public sympathy for the poor, 
simple-minded, foolish husband, he was acquitted under the 
'unwritten law.' "* 

Fifty-three out of one hundred talesmen summoned for 
the trial of Policeman McNamara, who killed his wife and 
James J. Brophy, a bartender, in the Royal Hotel, St. 
Louis, last August, declared that they were opposed to 
capital punishment, or would not inflict the extreme penalty 
upon one who took the law in his own hands "to defend 
the honor of his home and name," as they called it. 

Brophy had just registered himself and Mrs. McNamara 
as "John Smith and wife," when McNamara rushed up to 
the clerk's desk, shot Brophy first and then killed the 
woman. 

McNamara, a tall, powerfully built man is charged 
with indignities to his wife, that he forced her to desert 



♦Denver Post, March 12th, 1907. 



The Unwritten Law in Our Courts. 



381 



him, was a member of the police force at the time he 
violated, by this murder, the law he swore to obey and 
help enforce. He is confident of acquittal of this dual 
murder, so insignificant is human life now and so slight are 
obligations of respect for law under the "protection of the 
home," even in a distant hotel. > 

Garland B. Moore, a rural mail carrier of Springfield, 
Mo., last December stabbed his sweetheart to death, be- 
cause she did not reciprocate his affection satisfactorily and 
his domineering desire. His attorneys offer a defensive 
plea of adolescent insanity. It is fortunate for society 
when these hebephreniacs, real or feigned, take their own 
lives, for then the breed, of mental unstables is stopped. 
But the penitentiary for life or the garrotting rope of the 
law is a good remedy. 

In Denver the telephone wires got crossed, a politician 
made a wrong connection with another citizen's wife. Un- 
pleasant, even hot words passed between the two. On 
her husband's return the lady, with tears in her eyes, tells 
him of the insult. Forthwith he goes with his ready 
revolver to the offending man. Hot words are exchanged, 
a drawn knife and a responsive pistol shot from the 
pursuer would have taken the other man's life, but for a 
timely dodge, resulting in a skin wound and a hole in his 
fedora, and the unwritten law is again vindicated, accord- 
ing to this man's notion. 

In Springfield, 111., a divorced woman (Mrs. Ollie 
Gibson), seeking a reconcilliation with her divorced husband, 
is approached while reading a repentant letter she has 
written, by a lover spurned (Peter Clarke), and shot in a 
crowded street car. The unwritten law rights a wrong of 
a woman changing her mind and repentant. 

In line with these homicidal .erotic psychlampsias are 
the less harmful and not so flagrantly law defying suicidal 
psychokinesias which are often manifest at the very be- 
ginning of puberty, prodromal hebephrenia and forshadow- 
ing psychoses and prodromal of it or paranoia if the 
suicidal attempts fail. 

In another instance in Springfield, 111, March 27, 1907, a 



382 



Charles H. Hughes. 



fifteen year old boy's love for a school girl of the same age, 
unrequited, caused him to take his life apparently. But 
the cause of the self destruction was erotic neurone centers 
overwrought, unstable and shocked beyond the normal. 

If all the psychic dyspareuniacs, seeking second-hand 
felicity are to be allowed to kill the so-called invaders of 
the. often pseudo sanctity of inharmonious homes, whence 
happiness has usually already flown before the shooting, of 
what use is it to make penal laws against other forms 
of wrong. 

The divorce courts of this country are widely enough 
open to marital victims of infidelity where the marriage 
compact has been esteemed as a joke, or as a fragile tie 
*t least, by one of the parties to the compact. 

Ordinarily well balanced physicians, clergymen, con- 
gressmen, eminent orators and other men of mark and 
merit in the public eye have sometime felt the annoyance 
and baneful influence of the persisting pursuing erotopath 
in society not from the lower walks of life either. 

The intensely erotic wife of Potipher, perhaps famishingly 
erotopatic also, might have made the faithful and strong 
Joseph yield had he been a weaker man erotically and less 
loyal to his master and upright than he was. He, too, 
under circumstances of less personal honor and self-control 
might have been a victim of the lex 11011 scripta and failed 
later to rescue the people from the threatened famine. For 
in those days, as we may infer, the unwritten law was in 
vogue, for Solomon* warned certain young men of his time, 
"void of understanding," against the possible danger of a 
dart through their livers should they be so unwisely wicked 
as to "hasten to the snare" and go unto the wife of a 
neighbor, when she enticeth him with loving entreaty and 
erotogenic perfumery and decorations of bed and person, 
"when the good man of the house is not at home," when 
"he is gone a long journey." 

Solomon, who understood impartially the psychology of 

*"With her much fair speech she causeth him to yield,— with the flattering of 
her lips she forced him. He went after as an ox to the slaughter; as a fool to the 
correction of the stocks; as a bird hasteth to the snare and knoweth not that it is 
for his life, till a dart strike through his liver."— Proverbs. 



The Unwtitten Law in Our Courts. 



383 



love and lust, appears to have known that women were 
blamable as well as men where the dominant tender 
treacherous passion was concerned. 

The erotohysteric and hysterically delusioned false- 
hoods of certain hysteric women, combining unlawful, 
morbid affection with morbid revengeful jealousy, the 
jealousy, deceit and erotopathy of the woman repulsed, if 
not scorned, as in the case of the daughter of Herod as 
toward the purer John the Baptist, are to be considered in 
some of these instances when, in consequence, murder 
follows and the so-called unwritten law is appealed to in 
vindication. 

The bloody combination of vengeful violence and mor- 
bidly extreme passion appear in this ghastly incident of 
history as a truthful revolting picture of the nymphomaniac 
erotopath transformed into a victim of violent necrophiliac 
passion. Dead or alive she would have him — pure and 
gentle John — no more fitted for sexual affiliation with such 
a woman than an angel with a devil, and through her 
erotopathic influence and her mother's over her mother's 
husband she got her erotopathic blood wish. 

Herod, of course, went free, though the accessory be- 
fore the fact, through the seductive influence of a charming 
young woman who danced lasciviously before him. Other 
men since Herod's time have thus fallen and finally sur- 
rendered after vainly pleading to be absolved of a rash 
femininely extorted and influenced promise. They have 
through similar influence committed unjust capital crime. 
There yet live other women to inspire and be the cause of 
unjust murder, no better at heart, no healthier in their 
love, no freer from revenge, jealousy and reactionary re- 
turning love. Women are yet existent so morbid that they 
could ravishingly embrace and kiss the dead, as passionately 
erotic as the morbidly erotic Salome. Such women yet 
have caused men and even kings to do their bidding. A 
case of record in a modern court shows where the cuckolded 
husband was induced by the plausible yet primarily erring 
cuckold wife to kill, for her revenge, the weak victim of 
her cuckoo call. In this remarkable case the odium of the 



384 



Charles H. Hughes. 



crime of adultery was fastened on the dead victim of a 
woman's deceitfully seductive lust, a murder threatening and 
murder inspiring woman, and the murderer went free of 
crime under an erotically unbalanced jury's verdict given 
under undue excitement, almost hysterical, to protect the 
purity and defend the sanctity of an erotically impure, un- 
sanctified home. 

Gentlemen of the jury beware of the plea of the un- 
written law of justification for murder where either a normal 
or a morbid woman's morbid erotism and the normal or 
morbid jealousy of a murdering man are concerned. Jeal- 
ousy and morbid love do not balance revenge or justice 
well. 

It is manly to protest against and avenge wrongs 
against the physical frailties of women and to avenge 
violence to her with violence, but it is wise to be cautious 
where the frailties of her erotic life are balanced against a 
man's life made violently forfeit and the summary taker of 
that life on trial for murder and vindication beyond the law 
of the statutes. 

The testimony of the dead is not before you and the 
erotopathic frailties of some of the women who sometimes 
victimize even strong men in their weaker nature and vice 
vena are not before you always in these cases. A part of 
this testimony is silent with the slain, another part is with- 
held and no alienist expert testimony to show you what 
morbid states of the love passion may exist in the parties 
concerned and their undue influence, for this sort of testi- 
mony has never yet appeared in such trials. You may see 
justice in some of these cases only as she stands holding 
her unevenly balanced scales in the shadow of the bounda- 
ries between right and wrong, "man all and only wrong, 
woman always and only right, and her champion and 
avenger hallowed in the light of unerring lovely woman's 
fidelity and purity, outraged by ruthless, sinful man." 

Try and separate the amorous saints from the erotic 
sinners among- women and try and consider, if your own 
home love bias toward the good, the pure, the beautiful 
will permit, see that there are erotic and erotopathic devils 



The Unwritten Law in Our Courts. 



385 



among women, as there are like devils among men and 
some of the former do not in their erotic life demeanor, 
justify the forfeit of a human life in their behalf and the 
freedom of the murderer, even as there are men whose 
crimes against women deserve the penalty of death by law. 

Remember that the partner in this crime or sin or 
disease or the unwillingly overpowered innocent victim as 
the case may be is dead and can bear no witness. "Dead 
men tell no tales." Bear in mind the chief witness against 
life and home was a participant willingly, or may be un- 
willingly, from disease in the sexual sphere of her own 
org-anism or may be in that of the slain victim, also con- 
sider the possible motive, not alone the inspiration of the 
murder, that may sway the mind of the story teller of her 
own dishonor and shame or perhaps uncourted assault, for 
the shielding and saving of the man arraigned for the kill- 
ing. Estimate justly, if you can, the true relations, 
probable motives and possible eroto-sexual disease impel- 
ling to the home desecrating act, whether in the man, or 
jointly in both and in the murderer, whether in the latter 
it be one of jealously and revenge, prompted by other and 
private motive or whether excited to the verge of mania by 
insanoid hysteria or nymphomaniac passion unrequited of 
the woman. It is not always insult and outrage that 
causes women to seek man's destruction. 

Here is another example of the law defying, unwritten 
law idea which comes to us as we write, March 12th: 

Albert ("Bugs") Nichols, a teamster, employed by the 
St. Louis Transfer Company, was shot . and killed by 
Howard ("Bum") Court, who conducts a restaurant at 
No. 512 Spruce Street, in a doorway at No. 509 Spruce 
Street, about 1 o'clock this morning. The shooting was 
the result of alleged abuse to Mrs. Emma Court in her 
husband's restaurant shortly before the tragedy. Nichols 
died on the way to the City Dispensary, and Court sur- 
rendered to the police shortly after. He admitted having 
shot Nichols. According to the police, Nichols entered the 
restaurant about 12:30 o'clock and ordered a sandwich. 
Mrs. Court says he refused to pay for it and cursed her. 



386 



Charles H. Hughes. 



She told the police that she then turned out the lights and 
said she was going to close the place. After Nichols left 
she returned and turned on the lights. Nichols is said to 
have returned and slapped Mrs. Court's face. He then 
went to the Mark Twain Social Club, at Nos. 507 and 509 
Spruce Street. The woman found her husband in a near- 
by saloon and told him of the affair. He is said to have 
invited Nichols out of the clubrooms, and the latter drew a 
knife. Court backed away and fired three shots, two of 
which entered the body of Nichols. He fell in the door- 
way and died at the city hospital. 

It might be said by some, if the woman's story is 
true, the man who assaulted her deserved to be shot. But 
that psychic state of society that permits society's laws to 
be put aside and self- adjudication substituted by murder, 
by any man on his wife's unsupported story of assault, is 
as insulting- to the sanctity of the law as other offences 
insult the sanctity of the home. This murder was not done 
in the home nor for the crime of crimes which all men 
execrate, but for an offense given by a teamster to a 
woman presiding over a night restaurant in the tenderloin 
district, and the murder was done at the instigation of an 
angry woman slapped by a drunken man and on her angry, 
unsupported story alone. 

Brain instability promoted by drink and fostered by a 
much and too rapidly developed unstable erotism, disregard- 
ing the restraints of the law, where there is a woman in 
the case, with erotic passion, jealousy and revenge dominant, 
augurs not well for the weigher of justice in American 
society and in the courts of the country. 

Half the world in our cities, especially in certain 
localities thereof, through bill boards, theatres and other- 
wise advertised lasciviousness, seems to be living under 
dominant, higher intellect damaging and moral destroying, 
sexual erethism, verging closely upon or passed beyond the 
rational boundary line of erotic normality. 

In trials for murder, under the unwritten law as a 
plea in defense it would be well to inquire of the jury 
panel not only if the unwritten law would be considered a 



The Unwritten Law in Our Courts. 



387 



justification, but as a new feature of jury selection, whether 
the juryman himself is erotically morbid and unbalanced. 

Many years ago in an eastern city a celebrated case 
got into the courts where a dentist giving ether was charged 
by the woman operated upon with ravishing her in the 
chair, the charge being a pure delusion resulting from the 
etherization. Since then the dentists have always had as- 
sistants where anaesthetics are to be given and also in 
other cases where anaesthesia is not required, as in teeth- 
filling, etc. The advent of the trained nurse and of anti- 
septic surgery requiring more assistants than formerly and 
the custom of having a special anaethetizer has prevented. later 
scandals resulting from hysterical erotopathic hallucinations. 
But with the country practitioner and gynecologist who has 
often to economize in service in order to make small bills 
within the reach of patients, there is still great risk in 
gynecological treatments and examinations of a certain 
class of neuropathic women, who, from a morbid hysterical 
egoism are liable to detail incredible erotic dulusions of 
sexual liberty and ravishment almost impossible of occur- 
rence in the ordinarily equipped gynecological examining 
and operating room. The marvellous, the impossible and 
mysterious are, like the fondness for receiving attention, 
closely interwoven in the psychic life of the erotic hysteric. 
With such it would be well for men either to have nothing 
to do or treat them only under observation of witnesses or 
in conjunction with women practitioners. 

The lives of innocent doctors have been taken and are 
liable to be taken any day in the present abnormal pre- 
ponderance of the unwritten law sentiment, where the un- 
supported statement of uncertain, or maybe morbid, minded 
women are taken for so much, and that of the man cannot 
be had for reason of his summary death, or if not dead, 
deemed of so little value by an erotically over-emotional 
jury because it is merely a man's discredited testimony. 

Out in the goldfield state of Nevada, a man follows 
and finds two adulterers, after a pursuit of many months 
and many thousands of miles. They are sitting at a 
restaurant table, dining cheerily together, each enjoying 



388 



Charles H. Hughes. 



the other's company. Both apparently happy in their 
mutual sin. The "wronged husband," as he is called, may 
have been the one most to blame, and the "ruined wife," 
though she seems happy enough in her ruin, who equally 
with the man, doubtless "had proclivity to sin" are met 
there suddenly. The male paramour, without time to draw 
or explain or pray, falls before the deserted husband's 
avenging bullet. The murderer mounts a table and proclaims 
the righteousness of his deed against the man, with no word 
of censure for the surprised and swooning woman. 

It is becoming the neuropathic fad now, as in the case 
of Mrs. H. K. T., for an erring woman to lay bare the 
secrets of her past erotic life, sometimes most dramatically, 
while sympathetical juries weep when they should be 
doing some cool logical thinking. Tales of moral erotic 
delinquency are told for a motive of freeing cuckolded 
husbands from consequences of murder, or from some 
hysteric motive, which only certain women have, and 
no man, not even an alienist and neurologist can always 
fathom without asking corroborative evidence save that of 
the overwrought husband's real or imagined wrong, and a 
weeping jury lets the murderer go back to the cuckolding 
arms of his murder-inspiring spouse. 

In Carthage, a Missouri city, in the month of March, 
a young doctor (Meredith) met his death, at the hand of a 
so charged outraged husband (Sanderson) from an asserted 
sexual wrong based on his wife's unsupported confession. 
The jury, as usual, in this case, though not on the usual 
ground of insanity, found a pretext of self-defense, though 
the young doctor was shot, before he had time for expla- 
nation or defense, in his own office. This murderer was 
acquitted. 

One of the strangest things connected with all this 
unwritten law business is the paradoxical proceedure of in- 
dicting the man often only pro forma and omitting to indict 
the confessed co-adulterer as accessory to the murder, 
whose acquiesence is by no means always coerced or over- 
influenced by the adulterer. 

This is one of the paradoxes of the law officers and of 



The Unwritten Law in Our Courts. 



389 



public sentiment when a women is in the background, as 
it is in the often wrong decision of juries in these cases 
when both the adulteress and the murderer should be held 
accountable. 

The psychology of crime and responsibility ought to be 
the same, ordinarily, in man and woman in these cases. 
Women's peculiar nervous infirmities and often hysteric 
propensities to exaggerate and portray erotic delusions and 
her menstrually excited psychanopsias, hysterical pseud- 
opsias, etc., alone excepted, and which ought always to be 
considered by judges and juries and husbands even, in 
estimating the value of her testimony, especially in a 
matter involving life or death. A woman may, under will- 
ful motive of provoking jealousy, tell a false story of ad- 
vances never made, and under morbid psychopseudopsia 
even tell of seductions that never occurred. 

The vagaries of the enceinte and the hysterical, cer- 
tain erotopaths and certain catamenially disordered depart- 
ures from propriety, as the often then exhibited drink 
propensity and hysterical fiction are condoned by man and 
extenuated on the testimony of psychiatric physicians as 
resulting from peculiar morbid states of her nervous system 
at such times in certain neuropsychopaths. They should 
be put in the balance and duly weighed also, when a man 
is under indictment for adulterous crime or his life has 
been made the forfeit by a jealous husband resorting to the 
unwritten law on a confession of her infidelity under influ- 
ences she may say she could not resist, and which man 
so often calls her shame, her ruin, but seldom her crime. 

A relative of the Strother brothers, overhearing a con- 
versation about that mistried case, goes into the hallway, 
transfers a pistol to his hip pocket, returns with the manner 
of an autocrat to the party conversing regardless of the 
right of free speech, and says the conversation is dis- 
tasteful to him his revolver wielding egotistic majesty, and 
unless it is turned from that subject there will be trouble. 

In a psychically balanced community, normal in its 
estimate of constitutional rights and not erotically perverted 
on this subject of eroticism and killing, this man should 



390 



Charles H. Hughes. 



have been put at once behind the bars and held for in- 
vestigation, as either an insanoid or criminal disturber of 
the peace and a threatener of other men's lives. 

A case occurred lately in Missouri where a woman 
with her paramour were condemned to be executed for the 
murder of her husband. The governor, for merely senti- 
mental reasons, that it might not be recorded that the 
fourth woman murderess in the history of this state should 
be hung, commuted the penalty of both to life imprisonment, 
the unnatural, fiendish woman, because she was a woman, 
and the paramour and partner in the crime, because it would 
not be right, in his opinion, to condemn the one equally or 
more criminal because he had made the murder a possi- 
bility and was the erotopathic criminal cause, as well as 
accessory to, the great crime. 

As we write, Virginia gives us another and most pain- 
ful record of erotic homicide, if the wires flash the truth. 
It is that of a young, loved daughter, despoiled of her 
womanly honor by the fiendish crime of a drugged drink, 
avenged in blood by the love and passion unbalanced 
father. Both the slayer and the slain are of the best 
families of that good and great historic state. If the girl's 
story be true state statutes have no punishment adequately 
fitted to such a crime. But what if the story should be 
but the delusion of a latent psychopathic, excited into 
morbid misconception of a sexual wrong by alcohol and 
hysteria, as may happen to women of the insane tempera- 
ment under alcoholic influence or hysteria, or ether or 
hasheesh, or atropia.* 

The sweet and high and almost holy sentiment of our 
noblest manhood for the true, pure woman, our mother, 
beginning with the earliest recollection of her nurturing 
care and love and continuing undivided until another 
woman, esteemed as sweeter and more lovely than ou r 

*The chief counsel for the accused was John Lee, the Lynchburg lawyer, 
who successfully defended the Strother boys. Accused— Judge W. G. Loving, 
manager of Thomas F. Ryan's stock farm. Crime— Killing Theodore Estes, April 
24th, 1907. Defense— Unwritten law; prisoner alleged Estes drugged and wronged 
his daughter. Prosecution enters a general denial. Principal witness for defense 
—Elizabeth Loving, defendant's daughter. The jury in this case almost imme- 
diately acquitted. After the trial the defense's attorney conceded the innocence 
of the slain young man Estes. 



The Unwritten Law in Our Courts. 



391 



mother, came into our life further developing an abiding- 
emotion of tender, considerate regard for all womankind 
that tends to sway our judgments, often blindly in behalf, 
of all women when it should not influence the reason 
wrongly against the just criminal conviction and punishment 
of such women as are not, nor never have been, nor never 
could be the personified purity, virtue and guilelessness 
of the woman we paint upon our memory neurones as the 
saintly mother of our infancy, or childhood, or the woman 
of all women of o.ir youth and early manhood heart and 
home, whom we yet hold dear and to be inviolate, if our 
strong arm might save her from the lustful leprosy of the 
stealthful ravishing lecher's lure. 

But the lustful and the murderous of the opposite sex 
are not all of masculine mind, nor are the pure in heart all 
and always of womankind, though the term uxoricide, 
which man in his erotic generosity toward his complement 
sex has coined, has no equivalent for men murdering 
women. When a woman, lured by, or luring- her paramour, 
singly or jointly, kills the man whom she has promised to 
love and honor, what but an overbalanced erotic sentiment 
extenuates her crime when the Governor of a Common- 
wealth commutes such a crime because the criminal is a 
woman. 

When a loved married woman wilfully descends in 
lustful adultery, deserting a faithful, devoted husband, as 
some of the women do, notwithstanding the illusory con- 
fidence and honor many right-minded and faithfully loved men 
have for the sort of women they only intimately know 
and love and revere, she "falls like Lucifer, never to hope 
again." Then why should man let himself be swayed 
by sentiment predominating over his reason against sin and 
crime, guised in the luring habiliments of women. There 
are women, as there are men, adept in criminal impulse. 
Lustful, lawless erotism and lustful perversions abide with 
many of them as with like charactered men. Men's minds 
are found in women's frames and brains and vice versa. 

The extension of the sentiment of leniency and ex- 
tenuation to women for the same crime, under the same 



392 



Charles H. Hughes. 



circumstances and environment, without the legitimate 
excuse of insanity, that would bring to the fullest lawful 
punishment is an illusioned sentiment and not an enlight- 
ened reason result. And the setting free of a male mur- 
derer when an erring women beyond the age of consent 
may have been in whole or in part the cause and makes 
confession thereof, is an injustice to collective, lawful gov- 
ernment and an evidence of instability of reasoning on the 
part of juries, because they are swayed by an erotically 
biased feeling for the women and the cause of the eroti- 
cally impulsioned man, which may, on careful cold con- 
sideration and examination be found to have been, as it too 
often has been, after all the facts have been later learned* 
an illusioned and delusioned impulse and explosion of jeal- 
ousy, frenzied, nonfebrile delirium of the love passion, too 
emotionally and too hastily, too unreasonably yielded to 
and unrestrained. 

These facts suggest, from a psychological standpoint* 
an additional line of inquiry of the jury talesmen in cases 
where the lex non scripta for the extenuation or acquittal 
of murderers whose possible erotic jealousy or probable 
erotic wrong has entered into the crime. In these cases 
the jurymen from the true psychological standpoint of com- 
petency should be asked if they could give the testimony 
of both man and woman precisely equal weight in their 
minds, and if each juryman were capable of inquiring into 
the culpability of the woman in the case, and into that 
unwarranted jealousy that might color the testimony of the 
man, and that the woman might be influenced in be- 
half of her husband to give exaggerated testimony. The 
condition and quality of the minds of both husband and wife 
in such a case being liable to be influenced to an extreme 
degree and to untruthful exaggeration, by motives of self- 
interest, i. e., self-preservation, the first law of nature and 
of revenge disproportionate to the actual crime, or possibly 
of the woman's approaches not being reciprocated, result- 
ing in a scorned woman's desire to be revenged, as has 
happened, as medical men know, in instances where 
feminine nymphomania and morbid erotopathy has been the 



The Unwritten Law in Our Courts, 



393 



moving mental influence with the woman. The erotopath 
in society can transform an upright and lawfully abstineant 
man's connubial happiness into a hell of morbid erotic im- 
portunity and scorned vengeance and slanderous suspicion. 

Good men, devoted and true, have married such ex- 
tremely erotopathic women, as women have married drunk- 
ards, hoping to change their morbid erotism, only to find 
their after life a hell, or to see other women or men en- 
tangled through unjust slander as to their love relations 
and their husbands or others unjustly slaughtered through 
dissemination of eretopathically illusionally conceived stories. 

The erotopath is abroad in the land, dangerous to life 
and morals, but not enough in visible and rightly under- 
stood evidence in our courts of justice. 

The shooting of an individual for an eroto crime, real 
or supposed, is not a dementia americana, as Mr. Delmas, 
in his plea in behalf of Harry Thaw, the murderer of 
Stanford White, claimed, for dementia does not shoot, or if 
it does, it does not plan and design to kill. The acquitting 
of an erotic murderer, on the testimony of the criminal and 
his wife, while it is not insanity, is an emotional insanoid 
state, which it were well for the law to better regulate 
than now by more rational jury methods and further 
penalties for that sort of crime, for the excuse of which 
the unwritten law is now too often, too confidently and too 
successfully invoked. Something, and something more and 
better than now obtains, should be written law on the 
subject. 

Virginia in her early days had her cavaliers who could, 
on right occasions, chivalrously defend life and honor of 
man or woman, but that escuagic cowardly display of this 
I once knightly virtue of our Virginia ancestors of colonial 
days, which can coolly take the life of a vulgar human 
i being who applies an oath to a woman without otherwise 
harming her, when a personal castigation or the degrada- 
tion of a penal sentence would be more appropriate, and 
the court that approves of the spilling of blood in self-made 
|law, for such an offense are not, at this day, comprehen- 
sible even to one descended of a Virginia and Maryland 
i ancestry. 



394 



Charles H. Hughes. 



In imitation of this false chivalry, a negro in the streets)! 
of St. Louis assaults another negro for the verbal offense I 
of calling him a "snitch," whatever that may mean inl 
the slang of the underworld of color, takes his life with 1 
a revolver and calmly walks away and surrenders himselfl] 
at the nearest police station, as though he had done a 
most chivalrous and meritorous deed in thus invoking andH 
executing the unwritten law.* 

A man abandons his wife, keeping her ignorant fori 
years of his whereabouts, returns home unannounced; the U 
town liar has lodged in his maudlin mind a suspicion ofl 
unlawful intimacy against a poor but charitable small store- 1 
keeper, and the vagrant non-provident deserter of his I 
family, before even going to his wife, seeks the man inl 
his place of business and kills him with the ready, but 1 
half incoherently expressed defense, "He ruined my home 1 
and I am glad I killed him." 

Erotism in its many morbid perversions, its inciting to I 
jealousy and revenge, its dominance over judgment and the J 
general brain and other nervous instability it engenders,! 
should not be allowed to be its own arbitrary judge, jury 
and executioner with its own self-devised penalty of possibles 
knife or pistol or poison. 

The nurturing of neurone instability in the erotic I 
spheres of the brain as in all others would seem to be a J 
pertinent subject of law and pedagogy just now. Though I 
pedagogics has concerned itself too much with cramming, i 
often to cramming the brain and mind with knowledge I 
alone, to the neglect, or partial neglect, at least, of the I 
physiological regulation of the mind's normal dominance in .1 
its inhibitory centers, over the erratic and unstable impulses 
of the propensities and passions. 

The right balance and control of the organism, bringing 
all in harmonious adjustment and regulation to rational i 
normal conduct, in the erotic, religious and other spheres I 
of the emotional life with dominant enlightenment, judg- 
ment and control should be the aim of right education. 

The brain-storm life, the psychokinesiac episodes, too | 

♦Killing of Hubert by McLean, March 16th, 1907. 



The Unwritten Law in Our Courts. 



395 



ready to see, under dominance of erotopsychic erethism and 
imagine the sanctity of a virtuous home violated against 
a viritous woman's will, the ruin of woman, only courte- 
i ously treated, as is her due, and too ready to take the 
• law and the pistol in hand, require a regulating and re- 
i straining influence in better trained and strengthened in- 
I hibitions of brain, helped to be strong instead of weak by 
i law, by level-headed judges and brain-balanced juries, that 
do not weep and wabble in their judgments because there 
; is a woman in the case. 

A valet in a New York family becomes enamored of 
his mistress and indicts a love letter to her, and on being 
promptly dismissed from service, returns, gets into his 
master's bathroom and attempts to kill him with a tenpin 
club. 

This unstable erotopath expressed no regret for the 
attempted murder of the man whose wife he wanted and 
thought his appeal to the unwritten law justifiable because 
she was mysteriously attracted to him and he could not 
help it. 

Asexualization and sequestration for awhile in an 
insane hospital would probably cure him of his double pro- 
pensity to lust and murder. 

An eighteen-year-old son of a St. Louis physician, 
with a step- mother since he was thirteen days old deliber- 
ately shoots his father without after remorse and to get 
even with him for displays of irascibility toward him, (some 
parental denials, his diplomas and savings money in bank 
and ordering him from home a year previous,) though the 
boy was in business for himself in a responsible and ex- 
acting railway office, which the good education his father 
|gave him enabled him to fill with precocious ability, a 
(position as assistant to the superintendent in the profit and 
[loss department of the Missouri Pacific Railway, which his 
^grandmother, with whom he lived, took him from, thinking 
Ithe tax too great upon his brain. He was regarded as an 
ipxpert rifle shot among his associates. "A fool's bolt is 
isoon shot." 

This young fratricide, reading daily, doubtless, of the 



396 



Charles H. Hughes. 



unwritten law acquittals and psychically unstable from the 
overstrain of cigarettes and work and indulgences beyond 
his years, (confessing to thirty daily) just out from the overtax 
of school probably, is a revelation, by imitation of the 
vicious extent to which the idea of the self righting- of 
wrongs, real or imaginary by bloody vengeance, is spreading 
among the neurotically unstable. 

This boy visits the house of his father, doubly armed, to 
demand money he considered due him with two loaded 
revolvers, to be sure the contemplated deed will not fail, 
because "he knew his father was the very devil when 
angry," and he expected trouble. His father was raking 
the lawn when the son arrived. He had entered the kitchen 
to get some seed to sow upon the lawn. His mother thinks 
he has come back for forgiveness, but he has come to ask 
his father for his diplomas and money in bank. His 
father answers him passionately, "If that is what you 
come for you had better get out before I wring your ears." 
The revolver is drawn and the father is shot, and shot 
again after he has fallen. 

The exaggerated egotism of an over-indulged, too 
rapidly educated, possibly brain-damaged youth, appears in 
this precocious youth's speech and conduct. He has been 
to Sts. Peter and Paul's high school and to a university. 
He wears clothes of a decided "varsity cut" and acts and 
talks as a "man of affairs." 

In his own estimation he is superior to his father and 
disdainfully meets him, as he is described in the press. 
He is unruly and troublesome at his home, but tractable at 
the home of his grandmother. His father lately acknowl- 
edged what others had told him, that his stepmother, whom 
he loved and always thought his own mother, was not his 
mother by blood relation. The withholding of this knowledge 
seemed to incense him against his father and greatly 
changed his feelings toward his mother. He is described 
in the press as having the "varsity" egoism that disre- 
gards the rights and feelings of others in hazing and im- 
perils what should be the golden rule aptitudes of the 
rising generation in our universities. Gratitude for parental 



The Unwritten Law in Our Courts. 



397 



care and education and respect for the progenitor of his 
blood and nerve have no place in this ungrateful, mentally 
unstable young man's heart. Filial love and duty have 
been supplanted by a "varsitv" and business egoism of a 
precocious, mentally rushed life, and his father is shot nigh 
unto death by his ungrateful, unfeeling hand, but finally 
recovers. 

To arrest and change into right mental action the too 
often recurring displays of mental instability and its disre- 
gard for statute law is a problem as great as the care and 
sequestration of the plainly recognized insane, imbecile, 
idiotic and inebriate. These insanoid neuropaths had better 
not have been born, and if this be a psychic truth it were 
important that methods of education, social customs and 
neuropathic emotional jury verdicts that foster the growth 
and psychic explosions of such homicides should be pre- 
vented. The times demand steady-brained, unemotionally 
warped men. 

These brain storms of selfish, vengeful, uncompunc- 
tioned, murderous, unrestrained impulse, these "flashes and 
outbreaks of the fiery mind'' of youth and "savage unre- 
claimed blood," neglected in normal inhibition training up 
to manhood, should be made to cease, through better train- 
ing and the engendering of progeny that will not make 
and execute unwritten laws and judgments, or in jury 
boxes, will not permit the written law of the statutes to 
be overthrown and disregarded by private personal ven- 
geance, nor subterfuges of pseudo insanity made to thwart 
the law of the statutes salutary punitive prescription, of 
late years too often ignored by emotionally excited and 
erotically hypnotized juries. 

A ruling such as was handed down in the Thaw and 
Loving cases, sustaining the non-impeachability of the chief 
woman witnesses in these cases, whose testimony led to 
these tragedies, would seem to be in accordance with 
•sound psychology if the ruling applies in all similar cases 
only to the verity of the testimony, stopping short of 
ruling out the question as to whether the exciting story was 
told. In all cases it ought to be shown that the story causing 



398 



Charles H. Hughes. 



the crime, whether true or false, was actually told, and told 
in such a manner as to impress it as truth upon the mind 
of the man or woman or child, and to incite him or her 
thereby to commit the murder. The mental effect of a lie 
accepted as truth may equal that of the truth itself, and 
a woman or a man may lie and thereby cause a killing. 

But the uncorroborated story of outrage by a woman, 
resulting in the death of a ravisher at the hands of her 
friend or relative, ought not to justify entire exemption 
from the legal consequences .of murder. 

In the case of Wm. G. Loving, tried at Halifax Court 
House, Va., when Judge Loving was on trial for the 
murder, April 22nd last, of Mr. Theodore Estes, alleged by 
the daughter, Miss Loving-, to have drugged or intoxicated 
and seduced her, though the prosecution maintained, with 
supporting witnesses, that Miss Loving's story was false, 
that she was not assaulted, and that the only truth was 
that she had drank too much, though not to unconscious- 
ness or inability to walk. There was no disarrangement 
of the undergarments or other objective physical evidences 
of sexual assa'ult upon the lady. 

The arraigned was given to inebriety, the medical ex- 
pert, Dr. Chas. M. Emmons, of Washington, testifying to 
Mr. Loving having brain disease and mental derangement 
from excessive use of alcohol. The drunken habits of 
Judge Loving for many years, it was maintained by the 
defense, had broken him both in mind and body and that 
his intellect and will power had thereby been greatly im- 
paired. Theodore Estes was unmarried, aged 27 years and 
weighed 115 pounds. 

In this case Dr. Emmons would not say that Loving 
is now insane, though believing him at the time of the 
killing to have had brain disease and mental derangement 
from chronic alcoholism. 

Dr. J. S. Dejarnette, superintendent of the Western 
Hospital for the Insane at Staunton, Va., testifying as an 
expert for the State, pronounced Loving angry, but not in- 
sane, on the same hypothetical biography containing the 
history of his inebriate habits, attempts at reformation and 



The Unwritten Law in Our Courts. 



399 



cure of habit by institutional treatment, etc., separation 
from wife, and daughter's story of seduction and the record 
of the killing of Estes. 

There is an element of extenuation in long continued 
inebriety and possible and probable deterioration of brain 
and mind integrity requiring a more extended analysis than 
the meager facts before us will justify, that should be 
considered in more or less complete extenuation in all cases 
of homicide, but which is not germane to the present inquiry 
and we will therefore not here attempt to discuss it. 

It would not be appropos here to discuss the propriety 
of a young lady riding out alone, whether on a public or 
private road, with a young man and drinking from his 
whisky bottle, or of her asking for or his offering a drink 
to her, or of carrying such a bottle unless he were in fear 
of accident or snake bite requiring whisky. But it is 
proper to consider the psychic effect of a daughter's ac- 
credited story of sudden ravishment through such means, 
on a father and his immediate and closely sequent con- 
duct. It is possible that such a father with impulsions 
exaggerated by alcoholic indulgence, and its morbid mental 
aptitudes might be in such unrestrainable state of mind 
and brain under all the circumstances of the Loving case 
as to commit an impulsive act which no power, except the 
Almighty, might restrain, as declared by the arraigned Judge 
Loving. Loving was acquitted and his counsel then admitted 
the innocence of his victim. 

We are not prepared here to decide this question 
definitely. Alcoholism is a breeder and inciter of suspicion 
in the brains and minds of its victims, especially as of 
marital and erotic infidelity, and women in conjugal and 
amorous relations to men are often the victims of its violent 
impulses, as a study of the psychiatry of morbid erotism 
and alcoholism and the records of divorce courts plainly show. 



THE 

ALIENIST AND NEUROLOGIST- 



VOL. XXVIII. ST. LOUIS, AUGUST, 1907. NO. 3. 



Subscription $5.00 per Annum in Advance. $1.25 Single Copy. 



CHAS. H. HUGHES, M. D., Editor. HENRY L. HUGHES, Manager and Publisher. 

Editorial Rooms, 3872 Washington Boul. Business Office, 3872 Washington Boul. 



Thi* Journal is published between the first and fifteenth of February, May, August and 
November, and subscribers failing to receive the Journal by the 20th 
of the month of issue will please notify us promptly. 
Entered at the Postoffice in St. Louis as second-class mall matter. 



EDITORIAL. 

[All Unsigned Editorials are written by the Editor,] 



A VICTIM OF BROMIDIA SELF -MEDICATION FOLLY. 
— After taking bromides for a period of five years to induce 
sleep, a man registered at the City Hospital as Arthur 
Hill, aged thirty-two, of 10 North Fourth Street, is in a 
cell in the observation ward in a critical condition. Hill 
was admitted to the hospital last Wednesday night. He was 
arrested on the street apparently intoxicated. He said he 
began the use of bromidia upon the advice of a druggist who 
prescribed it for insomnia. Gradually he was obliged to 
make the doses larger until just before his arrest he says 
he habitually drank a glassful of the drug, enough to kill 
twenty men, every night. (This statement is a hashesh 
delusion.) 

This case is described as a victim of bromides. He is 
rather a victim of self and druggist prescribing folly and 
medical egotism. This prescribing by pharmacists should 

( 400 ) 



Editorial. 



401 



be interdicted. The little therapeutic learning the average 
pharmacist acquires from the dispensatory and the reading 
of physicians' perscriptions, without the necessary patho- 
logical and clinical knowledge, is a dangerous thing to peo- 
ple who trust in them for medical advice. 

Such cases are legally actionable and damages should 
be sought by their victims, or their friends in case they 
die, from taking the wrong medicine or in wrong doses for 
their maladies or continue the druggists's treatment till 
they become grossly or fatally ill before a competent 
physician is summoned. Physicians should not let their 
prescriptions go to counter-prescribing druggists. 

Battle's bromidia is an excellent combination adminis- 
tered judiciously with medically directed skill, but no drug- 
gist should prescribe it and no patient should take it on 
the judgment of a druggist or at his own blind discretion. 
A combination of fifteen grains of chloral and an equal 
quantity of bromide of potassium with a fourth grain of 
cannabis-indica and a like quantity of hasheesh or cannabis- 
indica, is about as safe a mixture in the hands of a drug- 
gist with an exaggerated medical ego, as a Colt's revolver 
in the hands of a little child, or a case of double 
pneumonia or of organic brain disease in the hands of an 
Osteopathist or Christian Scientist. 

THE CALINGAS OF LUZON described in clinical medi- 
cine by Dr. Thomas E. Moss of the Philippine constabulary, 
who think that heads from neighboring tribesman are neces- 
sary to propitiate the crop gods and save them from 

| starvation are superstitiously deluded, but sane murderers. 
Their head hunting murderous propensity is in harmony 
with their superstitious nature. Yet there are pseudo 
experts who testify before courts that similar heinous 
crimes, in the criminal class, for purpose and motive are 
acts of insanity. Not the act itself, but the brain disease 

i that impels it makes the insanity. 

THE INSANITY OF KING OTTO of Bavaria continues 
and Dr. Von Grashen the Bavarian alienist continues his 
weekly medical attentions. The King has just passed his 



402 



Editorial. 



sixtieth year and his malady is probably confirmedly chronic. 
The lucidity which appeared at times reappears no more, 
it is said, and a settled prognostically unfavorable dementia 
is said to have settled upon him. 

The monarch no longer sees the relatives whose psy- 
chologically unwise visits used to irritate him. This prudent 
and curative custom of interdicting visits and letters to 
patients from the punctum et origo of their malady is as 
salutary for plebians as for kings, though not of much 
significance after the stage of secondary dementia sets in. 

THE PURPOSES OF THE PUBLIC HEALTH DEFENSE 
LEAGUE are among: other things, to combat indecent and 
immoral advertising in newspapers; the sale of alcohol, 
opium and other injurious substances under the guise of 
"patent medicines;" the practice of medicine by ignorant 
quacks and criminal charlatans; the adulteration of foods 
and drugs by dishonest manufacturers; and the mailing to 
our young men and women at College, of obscene printed 
matter under the 4 guise of medical literature, making a base 
appeal to baser passions. 

We are in cordial sympathy with this, a militant society, 
for the welfare, moral and physical, of the people. 

Prompt responses have come from every section of 
the country, and the universal interest manifested is most 
encouraging. 

The necessity for such an aggressive organization as 
the Public Health Defense League, is apparent to anyone 
who knows and thinks of the moral and physical unsanitary 
peril of the people. 

We cordially send our name and dues in answer to the 
secretary's solicitation for enrollment. 

KUROKI AND GAGES SKULL. — The skull of Phineas 
P. Gage with the tamping iron that was blasted through it 
was shown to General Kuroki at Harvard with the history 
of the man's recovery and a twelve year lease of life 
thereafter, with his intellect and ability to earn a livelihood 
remaining. This ought to have made a good impression on 
Kuroki as to the endurance of the American skull and brain. 



Editorial. 



403 



The death of the veteran, Dr. John M. Harlow, May 
15th, who was the physician of P. P. Gage, also recalls 
this remarkable case. It came under Harlow's care from a 
mine near Cavendish, Vt. Gage was tamping a charge 
for blasting, Sept. 13th, 1848, which went off unexpectedly 
sending the tamping through the left side of Gage's head; 
going in at the ramus of the sight and coming out behind 
the eye to the right of the median line and in front 
of the fronto parietal section. He afterwards developed 
inebriety and epilepsy but no aphasia. 

CRITICISM OF THE RULINGS OF JUDGE FITZGERALD. 
— That Justice Fitzgerald does not appreciate the rights of 
the insane represented by experts and maintained by other 
courts and insisted upon by Ray with general judicial 
approval, appeared again most forcefully when Dr. Evans 
was under cross-examination. At a certain point of the pro- 
ceedings the expert justly maintained that to be forced to 
answer certain questions without qualification would be 
unfair to his professional reputation, the court instructed 
him sharply that it would be necessary to conform with 
the rulings of the court for all that. "There are some 
limits even to the conduct of an expert," said the judge. 
It may be answered there are n® just limits to the quali- 
fied answer and opinion witness may wish to make. 

The expert and his attorney ought then and there to 
have said such ruling was unfair to the prisoner, illogical, 
extrajudicial and unjust. The judiciary should aid and njot 
embarrass an expert in the search for psychological fact, 
by allowing- him to make such qualified answers as the 
logical rights of a true inquiry as to the existence or non- 
existence of insanity justly demand. 

Another singular proceeding in this remarkable trial was 
the request for postponement in putting on one of the 
defendant's witnesses, in order that the prosecuting attorney 
might first have a conversation with him to avoid objections 
he might raise if the witness should go on the stand without 
such preliminary inspection of and admonition as to the 
nature of the defense's witnesses' evidence. Such admoni- 



404 



Editorial. 



tory espionage of testimony by opposing counsel, appears 
egotistic, autocratic and unjust legal tyranny, also violative 
of the rights of the witness and of the prisoner to "the 
truth, the whole truth and nothing but the truth" as the 
oath reads in his cause as well as the duty of the witness 
under his oath. 

Chief Justice Fuller, of the United States Supreme 
Court, in describing (in the Atlantic Monthly) Abraham 
Lincoln's honesty at the bar, relates how, on a certain 
occasion, when Lincoln, having been appointed to defend 
a man charged with murder conducted his case. 

The crime was a brutal one; the evidence entirely 
circumstantial; the accused a stranger. Feeling was high 
and against the friendless defendant. On the trial Lincoln 
drew from the witnesses full statements of what they saw 
and knew. There was no effort to confuse; no attempt to 
place before the jury the facts other than they were. In 
the argument, after calling attention to the fact that there 
was no direct testimony, Lincoln reviewed the circum- 
stances, and after conceding that this and that seemed to 
point to defendant's guilt, closed by saying that he had 
reflected much on the case, and while it seemed probable 
that defendant was guilty he was not sure, and, looking 
the jury straight in the face, said, "Are you?" The 
defendant was acquitted, and afterward the -real criminal 
was detected and punished. How different would have 
been the conduct of many lawyers! Some would have 
striven to lead the Judge into technical errors. Others 
would have become hoarse in denunciation of witnesses. 

The simple straightforward way of Lincoln backed by 
the confidence of the jury won. And this and other like 
methods, let me add, secured for him the name of Honest 
Abe. 

The Lincoln method was not practiced by the prose- 
cuting attorney in the Thaw trial. Thaw and his experts 
were not given the benefit of the doubt through any sugges- 
tion or admission of the prosecuting attorney or rulings of 
the presiding justice. 

The following noteworthy occurrance evincing indefen- 



Ed torial. 



405 



sible bias and prejudice against an expert on insanity on 
the part of the prosecuting, attorney is here recorded from 
the press statements made at the time; Dr. Charles H. 
Wagner superintendent of the Binghampton Insane Asylum, 
who had just been a witness for the insanity of the 
defense, tried to describe a visit to Thaw in the Tombs on 
December 19th, when he was accompanied by Dr. Evans, 
superintendent of the Morris Plains Asylum and some of 
the defendant's lawyers. Mr. Jerome objected. He did not 
permit any of the conversation on which the conclusion of 
the expert was based. The witness turning to Justice 
Fitzgerald said he could not go on when the court broke in 
with "Well you can't testify." 

During the short recess District Attorney Jerome alked 
out of the court room and lit a cigarette. 

Doctor Evans expert for the defense extended his hand 
to the District Attorney in the corridor who ignored the. 
doctor saying he did not think the doctor was a truthful 
man. "Well you are no gentleman" said Doctor Evans. 
Mr. Jerome then walked away and the incident was closed. 

A good deal of feeling to inject into a case, against a 
witness in behalf of a man whose life was at stake, in the 
balance between possible insane exculpation and the ven- 
geance of the law. 

This rude remark was made to an expert of merit 
whose testimony was based on real clinical experience in 
psychiatry, and on personal examination and conclusion, 
not to one of those crude, egotistic, pseudo experts who, 
without justifying clinical experience and adequate and 
right study of the case and just capacity and opportunity 
in clinical experience for right reflection thereon and com- 
parison of the sane with the insane, boldly rush into 
forensic psychiatry, as illy posted lawyers sometimes do 
and pose as psychiatric experts, only, to betray, in their 
testimony and on cross-examination their ignorance of the 
subject, to the harm of themselves and the cause of that 
exalted branch of medical science, real psychiatry, which 



406 



Editorial. 



has its foundation in extensive knowledge of the human 
mind under the perverting influence of disease. 

Since the above was written February 15th more liberal 
rulings in behalf of testimony appear in this trial. 

SHALL STATE GO BACKWARD WITH ITS INSANE. — 
"Every state hospital for the insane in Illinois is so over- 
crowded to-day that, unless more room is provided, it will 
be necessary to return insane patients now receiving state 
care to almshouse care. This most unfortunate step can be 
avoided, and curative treatment of the highest approved 
value can be provided for all the insane wards of the state, 
if the forty-fifth General Assembly and your excellency 
approve the recommendations of this board in its 19th 
Biennial Report. In the name of humanity and progress, 
we, as members of the state board of charities and as 
individuals, recommend complete state care for the mental 
defectives of Illinois at the earliest practical date." 

The day of the dement cribbed and confined or chained 
to an outhouse or cellar floor should pass forever from this 
enlightened land. For striking off their chains Chiarage 
and Pinel became immortal. 

A RHAPSODY ON EXODY.— The St. Louis Times utters 
the following rhapsody on the season's exodus of Ameri- 
cans to Europe which will be appreciated by those globe- 
trotters who" have seen the attractions of both the old and 
new world and found, after all, that there is no place like 
the home land for sights of grandeur, beauty and glory. 

"Now are we upon the time when our friends possess- 
ing the price are wont to look up sailing dates, to make 
agreements with the man from Cook's. We find in the 
lists furnished by the steamship companies many familiar 
names. We say good-by to friends who will soon be 
traversing the Via Appia, mounting the crags of Scotland 
or sitting up with the midnight sun at Trondjheim or 
North Cape. 

"Sailing out of New York or Boston or Baltimore 
harbors is a pleasant diversion. It is likewise amusing and 



Editorial. 



407 



somewhat instructive to watch for whale and porpoise 
while playing the shuftleboard on the deep briny. It is 
lovely to stand on London Bridge when it is not falling 
down and to drive through the Latin Quarter looking in 
vain for an artist with a ragged coat and the shimmer of 
genius gleaming through unkempt hair. It is perfectly 
charming to see where the Princess died in the Tower, 
and it is more than entrancing to smell the decaying vege- 
tation that makes the canals of Venice give up an odor 
like unto Chesley Island in the good old summer time. 
We know of nothing quite as compensatory as the stifling 
heat of Water-port street in Gibraltar or the fly-populated 
spaghetti that makes for local color in the environs of that 
dear old Naples. 

"All of these things are good, But of the throngs 
that go to Europe every summer, raising the rents of Paris 
and the price of Southdown mutton in the grill room of 
the Hotel Cecil, how many know of the grandeur of 
Golden Gate and the myriad geysers of Yellowstone Park? 
How many have floated down the rough bosom of the 
Columbia, the Rhine of America, from the Dalles to the 
confluence of the Williamette? How many have shot the 
rapids of the St. Lawrence and how many of those who 
fly to Europe have stood beneath the shade of a tree 3000 
years old in the land of the redwoods? Where is there in 
Europe the mountain scenery that compares in extent and 
variety with what Colorado, all to itself, has to offer? 

"We commend Europe and the instruction of travel 
there to the fortunate who can foot the bills, but we take 
the liberty of suggesting that America is the real wonder- 
land and that to view it first is not only a patriotic duty, 
but a way of fixing high standards that the older world 
will have difficulty in matching. 

A DEADLY LIVELY. — A telegraph operator twenty-five 
years of age, as S. V, Lively was, deprived of sleep and 
working Tuesday, Wednesday and Thursday night and 
day without rest — seventy-two hours — becomes deadly for 
sleep. No wonder that terrible Florence, Colorado, R. R. 



408 



Editorial 



collision happened last year, and later ones have occurred 
since from similar cause, as in Texas. If no better provision 
is made for good and daily well -repaired mental machinery 
of telegraph operators the trains had better stop running, 
and people quit traveling by rail. 

THE ST. LOUIS CENSOR AND THE THAW TRIAL — 

The Censor of this city, makes the following comments on 
Thaw, his chief attorney and his jealous enemies in the 
legal profession, and Judge Fitzgerald, who presided in the 
famous case, captioned "Bumptious Provincialism." 

"When it was announced that Delmas was to conduct 
the case, the envies and jealousies and meannesses of the 
big city began to bristle. New York knows it all; nobody 
who lives outside of New York has a right to know any- 
thing. The presumption of Delmas in coming to New York 
was an insult, not only to New York's bar, but to New 
York itself. It wanted to see him fail, and it did all it 
could to defeat him. Jerome realized this prejudice and 
took advantage of it at the beginning by playing the part 
of a legal ruffian toward Delmas. Beyond doubt, Justice 
Fitzgerald was saturated with this prejudice at the begin- 
ning, and ruled uniformly in favor of Jerome, until the un- 
failing courtesy, urbanity and marked ability of the San 
Franciscan seem to have won him entirely. The press was 
imbued with the prejudice. They never lost an opportunity 
to give Delmas a sly, spiteful, little dig. 

"The hypothetical question framed by Hartridge, Fitz- 
gerald refused to admit, while Gleason, in placing Dr. 
Wylie on the stand, furnished Jerome his only triumph 
and almost broke down the case of the defense at its very 
opening. The action of these men in blaming the dis- 
agreement of the jury on Delmas is thoroughly contempti- 
ble. It shows the odds against which Delmas contended, 
for every one of these men, sitting behind him and sup- 
posed to be helping him, were betraying him and his and 
their client every hour of the trial. They would have 
secretly rejoxed in a first degree verdict, for that would 
have discredited the man whose misfortune it was— or 
should we say crime? — of not being a New Yorker. 



Editorial. 



409 



"The well nigh too heavy handicap carried by Delmas 
was that he had a fool for a client — a headstrong, degenerate, 
ego-maniacal fool, if not a lunatic, who in his bone-headed 
folly was governed by the notion that his money rendered 
him a superior being— a fool who had always been spoiled 
by having his own way absolutely, a fool with but a 
glimmer of reason, no knowledge of law, logic or anything 
else much, but yet who insisted absolutely on directing his 
own defense. This obstinate egomaniac has made all kinds 
of changes in his counsel since he committed his crime, 
putting first one lawyer then another to the front as 
leading counsel at a critical stage of the trial, and ordered 
him to dismiss Dr. Hamilton after he was on the stand, 
as he didn't want it shown that he was insane now or 
when he shot White. For this fool is said to have been 
thoroughly convinced, that on the ground of the unwritten 
law, the jury would acquit him without leaving the box! 
Jerome saw how matters were going and was entirely right 
when he charged that the fool was incapable of directing 
his counsel. 

"The fact is that Delmas won a great victory when 
he secured a hanged jury. He did well to defeat a first 
degree verdict. However, the employment of Delmas to 
conduct the defense was a mistake solely on the ground 
of New York's dense, ignorant, unthinking, crucifying pro- 
vincial prejudice. Not the most remote village in all the 
land is more provincial than this great city. There is 
nothing quite so insolent, egotistic, self-satisfied and in- 
sulting as this provincialism on earth. At least two 
millions of the city's population know nothing about the 
balance of the country and care less. A great many New 
Yorkers are convinced New York has furnished all the men 
of light and learning the country ever had. 

"The appearance of a lawyer from San Francisco was 
an insult to all New York — an insult which is now being 
resented with bumptious, bigoted vigor." 

INSANITY AND RESPONSIBILITY.— According to the 
Buffalo Medical Journal, a citizen of Kentucky was recently 



410 



Editorial. 



placed on trial by a jury at his own request and sent to 
the asylum on his own testimony. He said that he had 
distinct impulses to kill his wife and children and burn his 
house and then kill himself. He feared these impulses 
would be so strong that he would be unable to resist them, 
hence his application to the court to be sent to the 
asylum, which request was quickly granted. He mani- 
fested great joy that he was to be restrained in such a 
manner that his wife and children would be safe. Such a 
case, says the Journal, as this raises the point as to ac- 
countability, particularly as to the right and wrong test. 
If this man had killed his family he would have been held 
legally accountable under certain applications of the right 
and wrong test, which holds that if the man knows the 
nature and quality of the act and knows that it is 
wrong, then he is to be punished. The fact that he 
recognized the act as wrong showed that he was rational, 
hence the court committed a man to the asylum who was 
rational, a gross miscarriage of justice, though it possibly 
saved lives. 

RIGHT, MR. TIMES.— "An ancient parchment lying 
before us says that 'good whiskie preventeth the veins 
from crumbling/ whereupon we arise to disagree by 
quoting present day pathology, which says that arterio- 
sclerosis arises not infrequently from a too copious appli- 
cation of alcohol inwardly." 

You are right, Mr. Times, but there are times of 
limited duration, when a timely draught or two adminis- 
tered with due medical precaution as to dosage and repeti- 
tion "doeth good like a medicine" in arousing a flagging 
heart and in widening an anemic arteriole and flushing 
with more blood and increasing the lowering blood pressure 
to a failing anaemic neurone. 

There is a temporary salutary use medicinally, but not 
as a beverage, for whiskey even in preventing the "veins 
from crumbling" so to speak, through the very arteriole 
dilations that drink induces in certain cases. 



IMPROVED HEALTH CONDITIONS ON THE PANAMA 
CANAL ZONE— From Chief Sanitary Officer, Col. W. C. 



Editorial. 



411 



Gorgas' report t'o the Chairman of the Isthmian Canal 
Commission we glean the following important information: 
Health conditions on the Isthmus of Panama during the year 
1906 have been very good. During that period we had only 
one case of yellow fever — a fatal case which occurred in 
May. Two deaths were from smallpox. A fatal form of 
pneumonia has prevailed among" the negroes, affecting the 
white force to a very small extent. In a total of 1,105 
deaths among employees from all causes, 431 were due to 
pneumonia. The epidemic of pneumonia commenced in 
October of 1905, and reached its maximum in July, 1906. 
These statistics for the year 1906 show that the health of 
the force as a whole has been kept at about what it 
would have been if working at home; especially among 
the white American employes, and that yellow fever has 
been eradicated. 

ANTIVIVISECTION DEFEAT — THANKS TO DR. S. 
WEIR -MITCHELL. — The bill to prohibit vivisection in 
Pennsylvania was dropped from the legislative calendar of 
that state, after an address in opposition to the measure 
by Dr. S. Weir- Mitchell. 

A measure to prevent undue cruelty and to stop public 
school vivisection and prolonged anaesthetized torture in 
non-scientific and unhumane hands would be approved by 
science. The heartless college students who can com- 
placently torture animals to death, or abandon them to die, 
as was done lately in St. Louis, just to see them writhe, 
with no definite scientific object in view, deserve con- 
demnation and punishment, and they should be prevented 
from indulging the instinct of cruelty. Vivisection should 
be permitted only to real and humane students of physio- 
logical science and under restriction to the true necessary 
purposes of science and under right precautions, such as 
prevail in the profession regarding antisepsis and anaes- 
thesia- Not by callow youths for cruel curiosity and the 
fame and infamy of deliberate and aimless brutality. 

A PITIABLE COCAINE SLAVE, miscalled a fiend, was 
before one of our city courts and fined for what the 
ignorant judge called his crime and his fault. He raved 



412 



Editorial. 



and was violent after his arrest because the drug was out 
of him and its absence left him crazy. 

A moderate restitution, honored judges, of the brain- 
damaging and mind-distorting drug and gradual withdrawal 
and suitable medical treatment with an added generous 
dose of liberal judicial and custodian official charity would 
restore these unfortunate, unkindly miscalled "fiends," to 
normal mental poise and freedom from their now almost 
fatal thraldom, as they are now treated under present day 
court and custodial ignorance. The "cocaine fiend," as he 
is cruelly called, is a psychopathically sick person, needing 
sympathy rather than censure, care rather than curses. 
What is true of the cocaine habitue, gentlemen judges, 
jailors and policemen, is true of the opium slave, the 
dipsomaniacal inebriate and some other drug enthralled. 
The term "dope fiend" was never concieved in charity, 
but in ignorant malice, malevolence and uncharity. Not 
fiend but fated without another's help. 

Consult De Quincy's "Confessions of an Opium 
Eater" for a record of an "Iliad of Woes," which only 
medical aid can relieve, or learn of the many sanitariums 
advertised in the pages of the ALIENIST AND NEUROLO- 
GIST for more light on the miseries and claims for com- 
misseration of these unfortunate victims of the automatic 
drug dominance over the once free but now enslaved will. 
Angels of mercy and ministers of grace! why are these 
psychically frail, pitiable creatures permitted to fall into 
the hands of the ignorant, who punish them by deprivation 
and violence for erratic displays of delirium, when their 
drug is out. No less difficult of self-control than the con- 
vulsion of epilepsia. It is high time that health boards 
and public officials should know the medical needs of these 
unfortunates and supply them with charitable skill and 
tender consideration. 

"A cocaine joint" has been found by the police where 
a negress purchasing cocaine from druggists resold it to 
amateurs in cocaine indulgence, and furnished quarters for 
indulging the habit and its peculiar orgies. Some arrests 
followed, but the gravity and peril to normal mentality of 



Editorial. 



413 



this vicious indulgence will not be rightly appreciated and 
dealt with till health boards and police departments better 
understand its degradation and dangers to the mental 
stability of its habitues and the imminence of neurotic 
degeneration following in the wake of this terrible form of 
inebriety. 

CRUEL AND ABSURD TREATMENT. — Edward Murphy, 
alias Edw. Quinn, attempted suicide in the holdover in the 
four courts, St. Louis, by hanging himself from the top of 
a cell with a rope made from his shirt. 

Murphy was fined $100 April 10 by Judge Tracy, who 
stayed execution, providing Murphy would leave the city. 

When arrested again Murphy carried on like a maniac, 
tearing his clothing from his body. He ended by trying 
to hang himself. 

Two turnkeys prevented him from accomplishing- his 
design. He fought three big policemen for a long time 
before he could be subdued and taken to the city hospital. 
He was suffering from cocaine poisoning. 

When courts thus ignorantly decide medical qustions, 
without right medical counsel, where are the rights of the 
afflicted? Oh, Egotism, how often is thy name law! and 
thy tyrant executive the petty, ignorant tyrant on the 
bench of a court of justice! 

THE TIME IS NOW PROPITIOUS for a new departure 
in the education of the young medical man. Let him be 
taught that he is an important factor in the economic 
development of this country. He has an inalienable right to 
demand the enactment of laws which he alone knows ought 
to exist on our statute books for his own and for the pub- 
lic's protection. In France, in Switzerland, in the German 
States, a medical man receives respectful consideration in 
this regard. He frequently is a member of the parlia- 
mentary body, and is an important factor in legislation. 
When the silly prejudice existing: in this country against 
the participation of physicians in civic and national reforms 
disappears, we can hope for the same conditions here. It 
is to be hoped that when finally the subject of medical 



414 



Editorial. 



economics will be intoduced into the curriculum of every 
medical college in the land, it will assist in bringing about 
the above consumation — so devoutly to be wished. — Cin- 
cinnati Journal. 

THE NUDITY FAD for children promulgated by Prof. 
Starr, of Chicago, is an anachronistic rennaisance of naked- 
ness not suitable to our latitude or time with its rapid 
changes of weather and fashion, save in some excep- 
tional days of the summer solstice, and not suitable then 
for our often too early developed erotism between the 
sexes. 

It is however, true that people in the vicinities of 
Chicago, St. Paul, St. Louis, New York, Boston, Phila- 
delphia, New Orleans, Memphis and other of our cities go 
away from the hot weather too soon for their welfare. 
They do not avail themselves long enough in the summer 
season of the healthful opportunity to perspire and give the 
sweat glands a chance to relieve the kidneys of a part of 
their prolonged vicarious water eliminating work or take due 
advantage of the chance to dress themselves as diaphon- 
ously as they might and should, excepting always our ladies 
in ball-room, opera and parlor costume. 

Infants and children are often over clothed, sometimes 
under clad, but we are not yet ready for costume reversal 
to the habiliments of South American barbarianism, and the 
Professor does not even countenance those suggestions of 
budding barbaric or primeval modesty as seen in the con- 
cealing breech- clout or the fig leaf as the latter is pictured 
on our first parents in the garden before they went out 
together troubled in conscience and in search of a change 
of diet and wearing apparel. They were early disciples of 
the nudity fad, but thev and their children came, after a 
time, to know better, through the forbidden fruit case. 
History repeats itself, and the same thing is liable to 
happen in Professor Starr's nude "kindergarten." 

JUDICIAL MISCONCEPTION AND WRONG DEFINITION 
OF A WOUND AND OF INSANITY. — In the case of J. B. 
Thompson vs. the Fidelity and Casualty Company, the 



Editorial. 



415 



United States court of appeals has declared that the meane 
ing of a "wound" is an abrasion, breach or rupture of th- 
skin. The skin must be broken, or there is no wound. 

Therefore a person who is beaten to a pulp with 
sandbags or stuffed clubs may not be wounded, if his skin 
be not broken. 

At once we see vast opportunities, and proceed to load 
a piece of rubber hose with lead in anticipation of the 
visit of the collector. We shall not "wound" him, but 
will make hash of his interior. His heirs and assigns may 
prove a case of simple assault against us, but no deadly 
attack. And so may we deal with all enemies to our 
peace and dignity. A brick in the midst of the sofa pillow 
will lend joy to the occasion of a social evening. We will 
break skulls, but no skins. 

Surgeons and lexicographers may argue until doomsday 
that the victims are dead, but the law, which speaks the 
last word, will say that there can be no "remains" where 
there is no wound. Daniel and not Noah Webster is the 
final arbiter of language and life, for life is but the inter- 
pretation of words. The law must decide, and the law is 
authoritative. 

But we grievously fear that between the law and 
Christian Science this material world will soon wholly 
vanish. They are getting together on so many points as 
to actual hurts and actual death. They will leave us, 
soon, no realities — only "Science and Health" and the 
"revised statutes." Perhaps Mrs. Eddy will yet adorn the 
supreme bench, and decide, what the law seems to con- 
tend, that all our social and political ills are but "mortal 
mind." 

A St. Louis city paper thus detects and exposes 
the fallacy of the U. S. Court of Appeals idea of a 
wound, "an idea characteristically judicial, but fallacious in 
that it excludes almost as many injuries to the org-anism 
as the definition includes." Most of the psychical shocks, 
as of a man falling from a certain height and alighting on 
his feet, and all of many psychic shock wounds which 
affect by arrest, disorder and physical damage to the or- 



416 



Editorial. 



ganism, not appreciable to the eye through skin abrasions, 
as arrested digestion, tachycardia, bradycardia and other 
shock and apepsia results, psychic icterus, diarrhea, etc. 
The legal definition of a wound is, clinically, as absurd 
as the judicial idea in some states of insanity — the rulings 
in the Thaw trial, and the New York statutes for instance, 
that to be insane one must lose the knowledge of right 
and wrong, when the insane asylums furnish ample proof 
that many insane knowing- right from wrong yet do the 
wrong under morbidly imperative conception and psycho- 
pathic impulse as resistless as an epileptic fit or stroke of 
paralysis. 

Psychic brain disease is no respecter of law's defini- 
tions or court's rulings. Expecting a lunatic to conform to 
such legal regulations as to what shall constitute legal 
insanity or go to the electric chair or scaffold, is like de- 
manding physically upright deportment of idiocy and right 
walking of scoliosis, a splayfoot or a sprained ankle. 
Disease of brain or body is a law unto itself which courts 
can not treat. 

FAILURE TO RECOGNIZE NERVOUS INFLUENCE IN 
HAND-WRITING by chirography experts socalled has been 
the cause, and still is, of many errors of conclusion, for 
the hand-writing varies under varying brain states, like 
the vision which some occulists do and some do not 
adequately recognize. But at Newark, June 22nd, at a 
hearing before Vice Chancellor Emory there was admitted 
in evidence a statement from W. W. Winner, a hand- 
writing expert, to the effect that certain letters alleged to 
have been written by Fannie J. Meyer, defendent in a 
divorce suit brought by Charles A. Meyer, actually were 
written by Mrs. Meyer. 

They were addressed to Ross Neary, a private detec- 
tive. It is said they contained incriminating statements. 
Winner's finding was in part that "the letters were written 
by the same hand that wrote the standards furnished him 
for comparison. In fact, there is no attempt to disguise 
the handwriting in any case, and whatever apparent differ- 



Editorial. 



417 



ences exist are due only to mood and influences of the 
nervous system at the time of the execution of the 
writing." 

LABOR'S RIGHT TO REST is natural and physiological 
and should not be abridged by over long- hours either on 
week days or on Sundays. Plain meals and self-served 
alcoholics give waiters, chefs and dispensers of drinks and 
saloon owners a chance to rest, recreation and acquaintance 
with their families. The Sunday "lid" is neither a church 
question nor an anti-liquor question. It is a question as 
to the right of workers in the liquor interest to a rest 
time off duty, such as other workers enjoy and need. All 
work and no relaxation is neither healthful to body or 
mind. Yet St. Louis witnesses the anomalous action of 
the West End Improvement Association in awarding and 
applauding the vicious sentiment of unceasing work for 
liquor dispensers and saloon owners. They have rest rights 
and demands as well as others. 

A WOULD BE PATRICIDE OF ST. LOUIS was lately 
judicially sentenced to two years in the penitentiary and 
paroled under a peace bond, after being told to stop smoking 
cigarettes. A boy eighteen years old, who pleaded guilty 
of shooting his father in a passion during a quarrel over 
a small money claim he had against his father. 

A lunacy commission reported him sound of mind at 
the time, though it said he may have been mentally un- 
balanced at the time of the shooting. 

This boy admitted smoking thirty cigarettes a day. 

The latent psychopathic instability in these cases 
requires a term of more restraint and habit regulation 
which an insane asylum gives better than any penal insti- 
tute. The state needs midway establishments between the 
lunatic asylum and the juvenile reformatories where such 
aberrant youths might be segregated and trained in self- 
restraint. They are psychopathic and need a residence in 
a psychopathic or paranoid hospital and a commission of 
level-headed physicians skilled in determining the insane 
and the spasmodic diathesis should decide whether they 



418 



Editorial. 



should or should not be emasculated, to save the raee from 
the possibility of more of their pernicious kind being engen- 
dered. 

This cigarette boy with a brain storm propensity to 
kill even his father and who meant to kill him, should not 
have been turned loose on bond. A bond is no security 
against hypokinesia. The morbid brain storm knows no 
law but the law of physical restraint. 

A BEE STING CAUSING FATAL TETANUS is the 
latest report, through the secular press. The death of the 
boy, aged four years, is reported as occurring in Phila- 
delphia, July 26th y ten days after the sting. The name is 
Ralph Foy. Physicians have so diagnosticated the singular 
case. We should like to know more of this case. 

DR. KUHN is the name of the new superintendent of 
the State Hospital for the Insane, Number One, vice Dr. 
Woodson, resigned. Dr. Kuhn promises innovations and 
reforms, but they have not been detailed to us. It is 
promised that the welfare of this institution of the North- 
west will not suffer by the change. 

A VISION AT THE VATICAN accompanied with an 
auditory hallucination of the Madonna del Carmine is 
announced as having occurred to the present Pope Pius X. 
This cerebral hyperaemia affecting the visual and auditory 
centers of his Holiness' cerebral cortex is said to have been 
caused by the brain-strain of tension between the Vatican 
and a large section of the German Catholics. Constantine 
the Great also had troubles and hyperaemic vision of the 
conquering cross. Likewise Mohammed saw and heard the 
invisible and the voices. 

A DELUDED CHR1STOPATH lately leaped from a third- 
story window in New York and died. He imagined himself 
endowed like a bird or angel to fly, though he had no wings. 
A patient of the editor's, before the insanoid priestess of 
Christian Science inspired to such folly, attempted to fly 
from the top of his barn, with crude artificial wings attached 



Editorial. 



419 



to his arms and landed on his head in a dung heap and in 
the lunatic asylum the next day. Both had better have 
been placed in such an institution before their calamity 
befell them. The first case showed too much consciousness 
and remembered detail for epilepsia and in the second there 
was no such suggestion and no sign of epilepsia. The 
latter remembered all the circumstance and when convales- 
cent said he had been a fool, which was true, with the 
qualification that brain disease caused the act of flying folly. 
Such folly should be shot before it flies. 

SOMETIMES IN OUR SOCIAL LIFE we see the erratic 
working of the unstable neurone on its way to greater 
degeneracy of function in chronicles like the following: "She 
married a man prominent in his county politics and society, 
and now a well-known horticulturist. Later she developed 
erratic tendencies, was divorced, and is now wedded to a 
Chinaman." The divorce courts of America are also fateful 
illustrative warning revelations in this portentous direction. 

THE UNSTABLE NEURONE AT BLEES ACADEMY, Mo., 
was lately in evidence in the unsoldier like insubordination of 
one or two cadet officers followed by an unmilitary mutiny 
of a silly part of the class of kids because of the enforce- 
ment of lawful discipline when, in all military organizations, 
the first and most honorable and essential duty of a soldier 
real or mimic, is to obey orders and maintain the force and 
effectiveness of the command. The neuronic instability in 
this case, however, did not reach the faculty. 

THE FARMER'S WIFE AND INSANITY.— From the 
country districts women generally preponderate in numbers in 
the insane hospitals. The reason thereof may be found as we 
have before said, in the isolation of routine, and the monoton- 
ous and solitary life of the woman. She is last to bed and first 
up in the morning, unremittingly occupied all the time, and 
overworked in harvest time. If there are protracted revival 
meetings in winter, she entertains the preachers, prepares 
meals or supervises them, and looks to the ways of her 
household late and early. She has not the diversions of 



420 



Editorial. 



the husband. She attends no stock sales, no "destrick 
skule," no political gatherings, goes seldom to town to make 
purchases and never to the great city to dispose of the 
products of the farm or purchase implements of husbandry 
and have a social time away from home with friends, as her 
husband does. She walks the treadmill of daily routine 
onorous duty alone and carries without the aid of diverting 
social companionship or change, her wearing monotonous 
life burdens, relieved of household cares only by additional 
burden of preparing- for an increase in the family, by child- 
bearing, lactation, child rearing and new care and solicitude 
for a "new member of the family." Race suicide is no part 
of her thought or creed while blind indifference to his 
wife's life shortening, or insanity ending burden, marks 
the thought and demeanor often of the pater familias as, in 
the early morning, or at even tide, resting from his daily 
labor, (his wife still at work,) he meditates on the profit 
of the corning or the garnered crop, thoughtless of the 
psychic suicide he is helping his wife to commit. For 
"evil in this world is wrought by want of thought as well 
as by want of heart." 

Farmers wives and farmers daughters in a state like 
Iowa lead strenuous, exacting, self-immolating lives. They 
work too much and have too long hours and too little 
diversion. A man brought his wife to me and said doctor, 
I cannot account for my wife's insanity. She was such a 
good faithful wife. She always kept the house in order. 
There was no foolishness about her. She never went 
anywhere. I said to him that was the reason she lost her 
reason. Her life was too solitary and too sedentary and 
without rest or diversion. 

SCLEROSED BLOOD VESSELS (NEW VIEW), 
according to Senator, deprived of their chalk are liable 
to suffer loss of resistive power. The withdrawal of the 
chalk, which, nowadays is put forward as the rational way 
of treating arterio-sclerosis, forms no cure of the disease, 
according to this logical observer. — Vide selections. 



Editorial. 



421 



THE ARIZONA MAN -WOMAN. — The sexual identity of 
De Raylan* the Arizona married man-woman, has been 
established. Baron Schlippenbach, a Russian at Chicago, 
was the most important witness in identification. 

The woman simply was a pervert, a monomaniac on 
sex substitution. The surgeons at the post-mortem exam- 
ination, found an abnormal adhesion of the. brain matter 
to the skull. There is nothing in the speculation that De 
Raylan took male attire because of crimes committed in 
Russia, compelling a disguise for safety. Though he had 
known her for twelve years he had never had a doubt 
about her being a man. 

De Raylan's naturalization as an American citizen 
becomes void, and she remained a Russian subject. It 
becomes the duty of the Russian government to see that his 
(her) estate is properly administered. A search for possible 
heirs is now in progress in Russia. There seems only one 
clew, and that is a letter, with a photograph, from a woman 
in St. Petersburg, who seems to have been one of De 
Raylan's many sweethearts. 

A PECULIAR DISPLAY OF PSYCHIC EPILEP-Y. — Dr. 
Marc Ray Hughes, Professor of Mental and Nervous 
Diseases in the Barnes University, now Medical Depart- 
ment of the State University, had a peculiar experience 
with a case of this kind on a street in St. Louis. A negro 
jn the precursory stage of an epileptic automatic seizure, 
grabbed him about the neck from behind as he passed 
under an awning, throwing his arms about the Doctor's 
neck unconsciously, after the manner of a double "strong- 
arm" hold-up. The incident happened in broad day light on 
a much travelled street. The Doctor's first impression was 
that some part of the awning had struck him, but being a 
neurologist he soon took in the situation, the succeeding 
mental confusion, incoherency and semi-catamose condition 
revealing the disease. A peculiar coincidence was the fact 
that Dr. Hughes had just left his clinic where he had 
been lecturing upon and demonstrating a case of epilepsy. 
The possible medico-legal significance of a case like this 



422 



Editorial. 



will be apparent to the alienist expert. The unique dis- 
plays of psychic epilepsia are many, far more than Hugh- 
lings Jackson or other writers on epileptoid have yet 
described. Here, as in grand mal, they may be more 
unique than the "antic postures of a merry- andrew. 

A RELAPSE TO BARBARISM in the treatment of the 
insane, is reported by the Board of Supervisors for 
Stephenson County, Illinois, of a Freeport almshouse 
insane patient, demented and attenuated to eighty or 
ninety pounds, and chained by her bare feet to a cell, to 
control her insane habit of stamping on the floor at nights. 
These chains had been thus kept on this patient for 
several years for this purpose. Shades of the humane 
Pinel and Chiarugi! when shall some people who manage 
almshouses become sufficiently humanely considerate of the 
brain distorted poor to send them to the insanity hospitals. 

Illinois has not too soon passed a law emptying all of 
her insane into the proper sectional hospitals. 

THE DEATH OF THEODORE TILTON recalls the un- 
reliability of a wife's testimony on a question of erotism 
where the husband is involved. She testified both for and 
against her husband in the famous Tilton-Beecher scandal 
trial. 

PROMOTING THE UNSTABLE AND CONSERVING THE 
STABLE NEURONE. — Conjugal fertilization of psychopathic 
ovaries with neuropathic semen transmitting the unstable 
diathesis, is bad enough for the human race, but to add 
to it the cultivation of erratic propensities in our col- 
leges, by permitting badly born and minded youth to 
indulge ludicrous, cruel vagaries of conduct is worse. It 
feeds an inherant fatal hereditary neuropathy on its wrong 
way through life. It should be the aim of our colleges to 
correct or stamp out hereditary psychopathic tendencies to 
wrong conduct. 

The psychopathic diathesis is not a desirable element 
for the brains of American college bred young men. It 
is a foolish young man, who glories in bizarre and often 



Editorial. 



423 



cruel psychopathic stunts and paranoid speech and conduct as 
displayed in many present forms of hazing. Mens stabilitatis 
et mens caritatis might be a good motto for the fraternities, 
the school and the campus at Columbia, Missouri, as well 
as Columbia, New York, not to mention others. 

The best outcome of a modern University would be 
level heads and a steady brains. Neither overstuffed with 
knowledge and conceit nor lacking in conception of 
and conformity to the proprieties and stabilities of normal 
psychic function. 

The abnormal expenditure of the unstable nervous 
energy of psychopaths and neuropaths is not always and 
inclusively displayed in convulsions, hysteria, insanity, 
tremors, etc. With paranoid leaders it may appear in 
extreme hazing. 

SUICIDE PACTS, etc., like that of the late sextuple 
tragedy among members of an Iowa suicide club of 
ladies, the youngest victim of this form of braininstability 
being twenty-three and the eldest thirty years old 
show a discouraging evolution of the unstable neurone in 
our seminaries for girls. These ladies lived in different 
parts of Iowa, were graduates of either the State 
University or State Normal School and were brain over- 
strained daughters of well-to-do farmers. All took the 
same poison (carbolic acid) at the same hour (8:00 A. M.) 
of different days between Monday and the following 
Friday, May 17th, 1907. 

The note of one Miss Carroll read: "To dear ones: 
Good-by. I am dying. 1 swallowed poison. I belong 

to a club. Miss is president. We all of us take 

poison together. Good-by. " 

The name of the president was obliterated after she 
had written it. 

It has been discovered, the suicides began on Monday 
when Miss Belle Wilson, living near Council Bluffs, took 
carbolic acid. She died on her knees, and before she left 
the breakfast table to go to her room remarked she could 
never lead a good enough life. Miss Hannah Tomlinson 
of Newmarket, la., following took acid, saying life was not 
worth living. 



424 



Editorial. 



THE WEEKLY MEDICAL REVIEW has become a 
monthly. A strong man vacated its tripod when Milliken 
left it for a larger place on the A. M. A. We wish the 
Review continued prosperity without premature menopause, 
with Dr. Warfield as a worthy warrior for its welfare. 

The journal of the A. M. A., with the addition of 
Milliken's virility joined to the psychic fecundity of Brother 
Simmons, will continue to bear good fruit. 

A CASE OF FOL1E RAISONANTE— COMMITTING A 
SANE MAN TO AN ASYLUM.— It is reported from Council 
Bluffs, Iowa, that an officer of the Omaha police force 
spent an hour in St. Bernard's Insane Asylum, at Council 
Bluffs, while the insane man whom Maloney had taken to 
the asylum walked away a free man, after convincing the 
asylum authorities that Maloney was the crazy man and 
that he himself had brought him to the place as a patient. 

Maloney started from Omaha with the patient and ar- 
rived at the asylum safely. The patient was not violent 
and wore no shackles. Within the building, as Maloney 
and his man entered a private room, the lunatic shoved 
the officer into the room and locked the door from the out- 
side. Then he turned the key over to the authorities, 
telling them to watch their man closely. Afterwards he 
calmly walked out of the building and disappeared. 

Maloney insisted that he was the officer and became 
violently angry because he was kept a prisoner. Finally 
he asked that the Police Captain of Omaha be telephoned 
for. The Captain arrived and Maloney was then released. 
The lunatic has not been re-arrested. 

STATE FAIR— NEW FEATURES.— The management of 
the State Fair to be opened at Sedalia, October 5th, will 
offer prizes for Automobile races and many of the speediest 
machines in the state will enter these contests. The great 
mile track 80 feet wide will furnish these machines a 
magnificent course, and phenomenal speed and exciting 
contests are assured. 

Prizes are offered for the best Fraternal Drill Team, 



Editorial. 



425 



both for Gentlemen and Lady teams, and these exercises 
will form an attractive feature. A number of teams have 
given notice of their intention to contest for these prizes, 
and close competition will add interest and excitement to 
the exhibition. 

THE AMERICAN ASSOCIATION FOR THE STUDY OF 
THE FEEBLE-MINDED held an interesting and instructive 
session at Waverly, Mass., June 5th, 6th and 7th. 1907. 

Following is the program, under the presidency of Dr. 
W. H. C. Smith, of Godfrey, Illinois: Address of Wel- 
come; Col. W. W. Swan, President Board of Trustees; 
Brookline, Mass. Response. President's Annual Address; s 
Dr. W. H. C. Smith; Godfrey, 111. "Notes on the Order 
of Birth of Mongolian Idiots;" Dr. J. C. Carson; Syra- 
cuse, N. Y. "Some aids in Administration;" E. R. John- 
stone; Vineland, N. J. "Training Schools for Attendants 
for the Feeble-Minded;" Dr. Chas. Bernstein, Rome, N. Y. 
"The Operative Treatment of Spastic Deformities in 
Feeble-Minded Children;" Dr. E. G. Brackett; Boston. 
Clinic and Stereopticon Demonstration of Cases of Mental 
Defect; Dr. W. E. Fernald; Waverly, Mass. "Reading 
and Language;" Miss Charlotte Hoskins Miner; Orange, 
N. J. "A Child Who Hears, Yet Cannot Talk;" Miss 
Margaret Bancroft; Haddonfield, N. J. "Some Special 
Types;" Miss Fanny A. Compton; St. Louis, Mo. 
"Methods for Speech Development Employed in the 
School;" Miss Florence Boyd; Haddonfield, N. J. "Sug- 
gestions Concerning the Psychology of Mentally Deficient 
Children;" Prof Naomi Nosworthy; Columbia University, 
N. Y. "Psychological Work Among the Feeble-Minded;" 
Dr. Henry H. Goddard; Vineland, N. J. "Some Cases of 
Mental Defect from an Out-Patient Clinic;" Dr. J. J. 
Thomas; Boston. "Demonstration of a Series of Defective 
i Brains;" Dr. E. W. Taylor; Boston. "The Special Classes 
for Mentally Defective Children in the Boston Public 
Schools;" Dr. David F. Lincoln; Boston. Demonstration 
of Gymnastic work, Competitive Games, etc. ; by the 
School. Visitation to Templeton Colony. 



SELECTIONS. 



NEUROVASCULAR PATHOLOGY. 

SENATOR ON THE CAUSES OF ARTERIO-SCLEROSIS. 
— .... From an anatomical point of view accurate 
knowledge of it is still of recent date, for it was only 
towards the middle of the last century that the changes 
which led to what is called arterio-sclerosis were minutely 
investigated by Bizot, Rokitansky and Virchow. By these 
and later investigations it was shown that under the name 
of arterio-sclerosis, or a deposit of chalk within the walls 
of the arteries, no one single hard and fast anatomical 
process is understood, but that we have also to do with 
certain precursors partly of an inflammatory and hyper- 
plastic and partly of a degenerative and necrotic nature,* 
and that it is these latter which in their further course 
lead to the deposit of calcareous matter within the vessel 
walls. We are told that these morbid processes begin 
sometimes in the tunica intima and at others in the tunica 
media, and that it is only by a later sequence that they 
extend to the other coats of the vessei walls. It is also 
probable that the starting-point is a different one in 
the various circulatory regions, one for the Aorta, another 
for the smaller arteries. In the Aorta, for instance, the 
changes certainly begin in the intima, under the form of 
endaortevitis deformans chronica (Virchow). In every case, 
and this is beyond dispute, the deposition of chalk is a 
secondary process, i. e., the calcareous material is only 
deposited in the walls of vessels previously diseased, and 
it thus follows that even in the event of our being suc- 
cessful in freeing them from the calcareous deposit, they do 
not by any means become healthy vessels. On the con- 

( 426 ) 



Selections. 



427 



trary, diseased vessels which have been deprived of their 
chalk are liable to suffer loss of resistive power. In any 
case, the withdrawal of the chalk, which nowadays is put 
forward as the rational way of treating arterio-sderosis, 
forms no cure of the disease. It would be well to point 
out here that it is very doubtful whether chalk once 
deposited in the vessel walls can be removed by any 
means at present at our command. 

We use the term arterio- sclerosis in its clinical sense 
as applied to such arteries as, owing to their position are 
palpable or visible, are found to be thickened, rigid, and 
in more advanced cases even tortuous. When matters 
have advanced so far that arterio- sclerosis can be recog- 
nized clinically, then it is extremely probable that not only 
the intima and muscularis, but also the adventitia are in- 
volved. The early beginnings of the disease cannot be 
recognized clinically with certainty, but in most cases its 
presence is to be presumed from certain aetiological data 
and functional disturbances. Among early signs great im- 
portance is generally attached to an increase in arterial 
tension. According to my experience this sign is a very 
inconstant one in arterio-sclerosis and indeed depends 
greatly upon the condition of the heart. Apart from the 
fact that the rigidity of the arteries places a serious obstacle 
in the way of determining the conditions of pressure with- 
in them, the clinical methods at our disposal only permit 
of the estimation of pressure over a limited arterial sphere, 
and changes may occur in the capillaries and in the 
arterioles in quite another sense than in the aorta and the 
large arterial trunks, in the peripheral spheres than in the 
cerebral and visceral. 

In deciding upon a rational line of treatment we shall 
perhaps do well to imitate the example of the ancient 
practitioners of medicine, who, being unable to command 
the rich stores of diagnostic technique which we possess 
at the present time, devoted a far greater share of atten- 
tion and care to therapy than to diagnosis, and who 
formulated definite rules and indications which should serve 
as a guidance in the treatment of all difficult cases. 



428 



Selections. 



The first of these indications is of course the indicatio 
causalis, since before everything else comes the task of 
dealing with the cause of the disease in as far as it can 
be recognized and is amenable to treatment. 

The second indication may be designated the indicatio 
morbi. This corresponds very nearly to what we to-day 
call "specific treatment," examples of which are to.be 
found in the dietetic treatment of diabetes mellitus, the 
mercurial treatment of syphilis, and the serum treatment 
of diphtheria. 

The third indication is the indicatio symptomatica. If 
in the course of a disease any symptom becomes especially 
prominent and is a source of trouble to the patient, such 
for instance as excessive vomiting or severe diarrhoea which 
exhausts him, and pain which robs him of rest and sleep, 
the patient's power of resistance is lowered by these 
symptoms and the general course of his disease is un- 
favorably influenced. It is here that symptomatic treat- 
ment assumes importance, but even then it must be carried 
out with due regard to the general condition of the patient 
and without neglect of other indications. 

The last or fourth indication is the indicatio vitalis. 
It concerns measures which are to be adopted when there 
is imminent danger to life itself, and requires no further 
description. 

Considering in the first place the causation of arterio- 
sclerosis, it has been pretty generally accepted on the 
authority of Traube, Senhouse, Kirkes and Huchard, that 
the disease has its origin in increased arterial tension. 
Many facts appear to confirm this view. It is known, for 
instance, that a condition of high blood -pressure accom- 
panies chronic nephritis, in which disease, as is well 
known, arterio- sclerosis often exists. Attempts have lately 
been made to give this view experimental support by 
artificially inducing a condition of increased aortic tension. 
This can be easily and certainly effected by the injection 
of preparations of the supra- renal body into the blood- 
stream. When such injections are continued sufficiently 
long, changes very frequently, but not invariably, take 



Selections . 



429 



place in the aorta which are in sone respects analagous to 
those occuring in arterio- sclerosis. But it has also been 
shown that these changes may also appear when increase 
of pressure is prevented by the simultaneous administra- 
tion of substances which counteract the effect of the first, 
i. e. t which lower pressure, such for instance as amyl 
nitrite, and that on the other hand they are produced by 
the injections of poisons which do not raise the blood - 
pressure at all but rather tend to lower it. It is therefore 
improbable that increased arterial tension alone is the cause 
of these changes, but some special toxic influence also 
plays a part. Anyhow, the changes which take place in 
arterio-sclerosis in the human body are not identical in all 
respects with the circulatory changes experimentally pro- 
duced by means of the above mentioned injections. How- 
ever produced, be it the result of advanced age, or owing 
to the effect of some exogenous injury stimulating the 
vessels to abnormal activity and perhaps also exerting some 
direct harm upon the tissues, clinical experience shows 
plainly that arterio-sclerosis is a degenerative disease. 

Arterio-sclerosis is to be observed as a nearly physio- 
logical occurrence in old age when all the organs have be- 
come degenerated and weakened, and when there can be 
no question of heightened blood pressure. Its occurrence 
in earlier life is generally due to the effects of syphilis, or 
of chronic intoxications such as alcohol, tobacco, and 
various metals, such as lead and mercury, and also as it 
now appears to carbon disulphide. I am also inclined to 
ascribe a certain aetiological importance to the long con- 
tinued use of strong tea and coffee, the extractives of 
meat and the products of curing, as well as to certain 
endogenous injuries arising from gout, diabetes and chronic 
nephritis, in the last of which, as Strauss has pointed out, 
nitrogenous bodies accumulate which are not proteids. 

I am also of opinion that the development of arterio- 
sclerosis is favored by the excessive consumption of nitro- 
genous food. The disease is not infrequently seen in 
athletes, who in the course of their training to reduce 
their weight consume little carbohydrate and fat and a 



430 



Selections. 



good deal of meat, sausage and cheese. The custom of 
partaking liberally in the early morning of meat, ham and 
eggs, may well be one of the causes of the prevalence of 
arterio-sclerosis. 

We know, for instance, that nitrogenous food causes 
the appearance of products of intestinal decomposition in 
far greater profusion than a vegetable diet, and it may 
well be imagined that by absorption of these products (to 
the injurious nature of which 1 drew attention as early as 
the year 1868), a condition of chronic intestinal auto- 
intoxication is brought about which may be a precursor of 
arterio sclerosis. 

Finally, arterio-sclerosis is frequently to be found in 
people leading a sedentary life which results in their be- 
coming very stout, and in women at the climacteric period 
who are notoriously disposed to obesity. It is quite possible 
that in consequence of insufficient movement and the con- 
stipation which is generally present and which is favored 
by the wealth of fat in the abdominal walls, the omentum 
and the mesentery, decomposition products are formed in 
the intestine in increased quantity, and it is also possible 
that increased pressure occurs as the result of sluggish 
movement of the blood caused by the deposition of fat and 
that this also precipitates the evil. — Abstracted from Lecture 
of Prof. H. Senator? of Berlin, on Causes and Treatment of 
Arterio -Sclerosis, in Folia Therapeutica No. 2. 

HAEMOTOXIC ETIOLOGY OF ATHEROMA AND 
ARTERIOSCLEROSIS. — Maurice Leoper (La Presse Midicale) 
states that atheroma and arteriosclerosis may be considered 
clinically as the result of slow or prolonged toxic irritations 
of arterial tissues. Recent investigators who have con- 
ducted experiments on some of the lower animals, have 
isolated from the supposed poisons substances with an 
action especially sclerosing or inflammatory, and others 
with a veritably calcifying action. The first led to the 
formation of sclerous endarteritis, the second group caused 
lesions of calcification very analogous to certain alterations 
of the middle coat of the human artery. Future investi- 



Selections. 



431 



gations will show if there are two groups of different causes 
to be considered in the double process of human arterio- 
sclerosis and atheroma. 



NEUROHEMATOLOGY. 

BLOOD IN ASTHMATICS.— Solecher (Meunchner Medi- 
linische IVochenschrift, No. 8, 1907) analyzed the blood of 
asthmatics and found that during and immediately after an 
attack an increase in the percentage number of leucocytes, 
the increase being solely at the expense of the polymor- 
phonuclear variety, while the mononuclear, and particularly 
the eosinophile cells showed a decrease. During the free 
intervals, on the other hand, the percentage of polymor- 
phonuclear cells sink as low as forty-five per cent, while 
the eosinophiles markedly increase. 



NEUROPHYSIOLOGY. 

CAUSE OF SOFT-SHELLED EGGS.— Poultry writers, 
since the time the Shanghai rooster first invaded Boston, 
have been repeatedly telling us that soft-shelled eggs were 
caused by an insufficiency of lime in the food consumed 
by the hens. Such, however, is not the case. The soft- 
shelled egg is a case of arrested development, due to nerv- 
ous interference with the functions of the oviduct. The 
laying of incompletely developed eggs corresponds to abor- 
tion in mammals, and can likewise be brought about by 
extreme mental disturbance. In experiments conducted at 
the Kansas Experiment Station the writer was able to 
cause the production of soft- shelled eggs by continued ex- 
citement of confined hens. It was also shown that the 
hen's system on an ordinary diet contains enough calcium 
carbonate for the formation of about five or six eggs. If 
lime was withheld from the food, the hen after having laid 
this number of eggs, will stop laying. When lime was 
given in limited quantities the hens laid apparently normal! 
eggs but only as frequently as the lime furnished would 
supply shell material. Careful weighings proved that eggs 



432 



Selections. 



thus produced, though apparently normal, were actually 
thinner-shelled than normal eggs from the same hen. — 
Scientific American, 



NEUROTHERAPY. 

VERONAL IN TREMOR.— Professor Combemale (Merck's 
Archives) has employed veronal in a large number of cases 
of insomnia from all causes, and has failed with the drug 
in only one patient, one with carcinoma of the stomach, 
where morphine could not be withheld. A new and very 
valuable property of the drug has recently been discovered 
by the author, namely, that veronal is an excellent anti- 
spasmodic, relieving the very severe and painful convul- 
sions of amyotrophic lateral sclerosis in a remarkable 
manner. Exceptional results were also obtained in a tremor 
of multiple sclerosis, hemiplegia, neurasthenia, delirium 
tremens and cerebral tumor. If it be remembered how dis- 
agreeable a symptom in multiple sclerosis the tremor really 
is, the value of the drug will be evident. The proper dose 
here is 0.5 gm. (7}4 grn.) every evening for several weeks. 



REVIEWS, BOOK NOTICES, REPRINTS, ETC. 



THE NERVOUS SYSTEM OF THE VERTEBRATES by J. B. 
Johnston, Ph.D., Professor of Zoology in West Virginia 
University. Price with one hundred and eighty illus- 
trations $3.00. P. Blakiston's Son & Co., 1012 Walnut 
St., Philadelphia. 

The author lucidly and intelligently discusses Waldeyer's 
neurone theory, tentatively states it in six propositions, the 
last of which viz: that the form and position of the 
neurones, especially the connection and disposition of their 
processes determining the pathways of impulses and hence 
the work done by the nervous system, includes, in his 
judgment its entire practical value. He considers "A knowl- 
edge of how neurones are linked together in functional 
systems is necessary for the pathologist and psychologist. 
The factors which determine the manner of linking neurones 
are the chief interest of the social psychologist, the educator 
and the social reformer." 

The entire book with its numerous, copious neuro- 
anatomical illustrations and elucidating context will entertain 
and repay in agreeably and profitably imparted knowledge 
of the authors subject any reader of the Alienist and 
Neurologist. We may recur to this valuable book again. 

THE DISEASES OF THE RECTUM: Their consequences 
and non-surgical treatment. By W. C. Brinkerhoff, 
M. D., Chicago, 111. Price $2. Orban Publishing 
Company, Chicago, 1907. 

Those who may have in their possession the greater 
works of Tuttle or Mathews or even of Bodenheimer and 
others will not specially need this little book, though there 
are some things in it which might be regarded as valuable 
addenda. 

( 433 ) 



434 



Reviews, Book Notices, keprints, Etc. 



The author's reference to the right use and kind of 
rectal syringe tubes and his cautions against the evils of 
the enema habit are worthy of approbation and his non- 
germane chapter on the legal limitations of medical practice, 
mat nppropos as it is to the scope of the book, will amuse 
the reader, especially if he should happen to be a professor 
in a medical school. 

CLINICAL PSYCHIATRY, a text book for students and 
physicians. Abstracted and adapted from the seventh 
German edition of Kraepelin's "Lehrbuch der Psychia- 
tric" By A. Ross Diefendorf, M. D. New edition, 
revised and augmented. The MacMillan Company, New 
York. 

This is a timely new edition abstract for the American 
and English reader of Kraepelin's Lehrbuch de Psychiatrie, 
the only omissions being "The general etiology, diagnosis 
and treatment in the first volume" of the distinguished 
author, the revisor deciding upon such points as are of the 
most importance and adding them to this department. 

The book will prove of value to the American physician 
interested in the study of psychiatry but we regret to see 
that so many of the author's methods of treatment are 
omitted, especially without the author's special sanction. 

FOLIA THERAPEUTIC A. — A copy of the second number of 
a new journal on therapeutics entitled the "Folia 
Therapeutica" has come to our notice. 
It will be the aim of this journal to devote itself to 
publications on the progress of modern therapeutics and 
pharmacology, and to present in a brief and concise manner 
the methods of treatment and preparations which can be 
safely recommended for use, and which constitute a real 
advance in therapeutics; and the evidence given for the 
reliability of any treatment or drug will consist in the 
unquestionable authority of the authors by whom, or under 
whose supervision, the investigations have been made. 
The names of the editors Baginsky and Snowman guarantee 
the worthy character of the journal. 



Reviews, Book Notices, Reprints, Etc. 



435 



We take pleasure in putting the same on our exchange 
list as requested. It is issued from 83-91, Great Titchfield 
Street, London, W. This new applicant for professional 
favor is published by Messrs. John Bale, Sons & Danielsson 
Ltd., Oxford House, Great Titchfield Street, London, W. 
The names of Sawyer, Senator, Taylor & MacKenna, 
Schmieden, Arnold Edwards, Barendt, Gossman and Brieger 
appear among the contributors to number two of these 
therapeutic folia of most excellent promise. 

A Plea for the Earlier Diagnosis and Treatment of 
Epilepsy. By M. L. Perry, M. D., Superintendent State 
Hospital for Epileptics, Parsons, Kas. 

Thirteenth Annual Report of the Craig Colony for 
Epileptics, Sonyea, N. Y., 1906. 

Medical Expert Evidence and the Bill Pending before 
the Legislature of Maine. By Clark Bell, Esq., LL.D., 
President of the Medico-Legal Society of New York. 

Therapeutischer Notizkalender fur Praktische Aerzte. 
Vierteljahrsbeilage zu Deutsche Medizinalzeitung. XXVI. 
Jahrgang 1905. 2 Heft. April bis Juni. Verlag von Eugen 
Grosser in Berlin SW. 

A Critical Analysis of the Expert Testimony in the 
Jack the Stabbcr Case. By David S. Booth, M. D., St. 
Louis. 

Neurasthenia, Traumatic and Idopathic; its Pathology 
and Prognosis. By David S. Booth, M. D., St. Louis. 

Alcoholism and the Narcotic Drug Habits. By B. B. 
Ralph, M. D., 529 Highland Ave., Kansas City, Mo. 

The Radical Mastoid Operation for Chronic Suppurative 
Otitis Media. By Hanau W. Loeb, A. M., M. D., St. 
Louis, Professor of Diseases of the Nose and Throat in St. 
Louis University. 

27th Annual Report of the State Hospital for Insane, 
S. E. District of Pennsylvania, Norristown, Pa., for the 
Year Ending September 30th, 1906. 



436 



Reviews, Book Notices, Reprints, Etc. 



Abnormality in Amniotic Secretion in its Relation to 
Fetal Malformation. By Joseph Brown Cooke, M. D., 
Adjunct Professor of Obstretics in the New York Polyclinic 
Medical School and Hospital, Surgeon to the New York 
Maternity Hospital; Visiting Obstretric Surgeon to the 
Misericordia Hospital; Fellow of the New York Obstetrical 
Society, etc. 

A Case of Landry's Paralysis with Recovery. By 
Wharton Sinkler, M. D., of Philadelphia. 

Protestant Hospital for the Insane, Verdun, Montreal, 
Que. Annual Report for the Year 1906. 

Central Indiana Hospital for Insane. To the Governor. 
1906. 

A Plea for the Simple Round-Ligament Ventrosuspen- 
sion. By B. S. Talmey, M. D., New York. 

The Food and Drugs Act as it Relates to Drugs. 
Examined and Explained in Connection with the Rules 
and Regulations for its Enforcement. 

Indiana Medical College, the School of Medicine of 
Purdue University. 

Report of the Department of Health of the Isthmian 
Canal Commission for the Month of February, 1907. By 
W. C. Gorgas, Colonel, Medical Corps, U. S. Army Chief 
Sanitary officer. 

The Growth of Neurology. Chairman's Address Before 
the Section on Nervous and Mental Diseases, at the Fifty- 
Seventh Annual Session of the American Medical Associa- 
tion, Boston, June 5-8, 1906. By Wharton Sinkler, M. D., 
Philadelphia. 

Monstrosities vs. Maternal Impressions. By George S. 
Courtright, M. D., Lithopolis, Ohio. Read before the Ohio 
State Medical Society and Published in the Transactions. 



Reviews, Booh Notices, Reprints, Etc. 



437 



Carcinoma. By J. P. C J awford, M. D., Davenpoit, 
Iowa. Oration on Surgery Read Before the Iowa State 
Medical Society, Des Moines, May 17th, 1906. Opening 
with the statement that there is no disease afflicting the 
human family that continues to be of greater concern than 
carcinoma, and noting the growing distrust in the efficacy 
of all therapeusis, surgical as well. At present the vision 
of success is not inspiring. To this vast company of suf- 
ferers this beautiful world is likely to continue a veritable 
charnel-house in the midst of life. The author thus gloomily 
concludes an able survey of this therapeutically discour- 
aging subject. The auahors surgical technique is admirable. 

A Review of the Opsonins and Bacterial Vaccines. 
By E. M. Houghton, Ph.C, M. D., Junior Director, Bio- 
logical Laboratories, Parke, Davis & Co., and Special 
Lecturer in Medical Department, University of Michigan. 
Directions for Determining the Opsonic Index of the Blood. 
By E. C. L. Miller, M. D., Research Bacteriologist, Depart- 
ment of Experimental Medicine, Parke, Davis & Co., 
Detroit, Mich. This is a good presentation of an interesting 
subject which every physician should read. It comes with 
compliments and approbation of P., D. & Co., which con- 
stitute a guarantee of merit. 



The Feeding of Infant 
in Diarrhoea, I 

Cholera Infantum, etc, 

Mellin's Food is a preparation for the modifi il 
of fresh cow's milk. In diarrhoea or in pronooi 
digestive disturbances when milk is contra-indi« 
Mellin's Food dissolved in water may be used ta 
rarily or Mellin's Food in whey. 

As soon as the stomach regains tone, a 
quantity of milk should be gradually added, unt 
proper proportions of Mellin's Food, milk and \ 
adapted to the age of the child, are reached. 

Mellin's Food in these cases is much to be: 
ferred to barley or other cereal gruels, as it is 
from starch, and therefore does not set up, but aa 
ly allays, intestinal irritation. 

We will gladly send samples free to you, Dei 
on request. 

Mellin's Food Co.. Boston. M|j 



PUBLISHER'S DEPARTMENT. 



NERVOUS EXHAUSTION.— Just as the continued ad- 
ministration of the Hypophosphites produces more solid 
bones whose chemical composition is "natural," so there 
are good grounds for holding that the steady, persistent 
use of the Hypophosphites will tend to produce a more 
complete development of an imperfectly evolving nervous 
system. 

TO INCREASE the muscular activity of the stomach 
walls, Gray's Glycerine Tonic Comp. has valuable 
properties. 

THE MEDICAL ERA'S SPECIAL EDITIONS.— The Med- 
ical Era, of St. Louis, Missouri, will conform to its usual 
custom and issue its yearly series of special Gastro-lntes- 
tinal numbers embracing July and August. The August 
issue will be given over entirely to the consideration of 
every phase of Typhoid Fever. The series will contain 
about 35 or 40 practical papers and will contain a large 
amount of valuable information. 

IN THE TREATMENT of the chronic skin inflamations, 
following in the wake of attacks of toxic dermatitis, at- 
tention to the general condition of the health, avoidance 
of anything irritating to the skin, a carefully selected diet 
and proper care of the skin are important features which 
must not be neglected. In addition, Battle's preparation 
of echinacea augustifolia and thuja occidentalis, which goes 
under the trade name of Ecthol, should be used both 
locally and internally, a drachm should be taken four 
times a day. — American Journal of Dermatology. 

BROMIDE TREATMENT. — No form of bromide treat- 
ment will prove successful unless the very purest salts 
are employed. 

( 438 ) 



ITS COVER PORTRAITS 

have made it famous 



AGE: TWENTY-FIVE YEAR 

—and still growing! 



7246 



PROGRESSIVE 
PHYSICIANS 



READ THE 
MEDICAL 
HERALD 



OFFICIAL JOURNAL 
MEDICAL SOCIETY 
OF MISSOURI VALLEY 



YOl 



MAY BECOME ONE 
OF THIS CLASS FOR 
ONE DOLLAR . . . 



Clean, Ethical, Newsy, Original. Un- 
trammelled by trade connections — unbiased 
in its utterances — and broad enough to re- 
nounce illogical traditions and narrow 
dogmas . 



Its Original Department reflects 
the progress of the stalwart Prac= 
titioners ol the great Middle West. 



The Oldest Independr 
Medical Monthly 
west of the 
Mississippi River 



EDITED AND FU 
LISHED BY MEDICO 
MEN: ITS AIM TO A] 
VANCE THE CAUSE C 
SCIENTIFIC MEDICIN 



CIRCULATES 
IN A FIELD 
PECULIARLY 
ITS OWN 



$1.00 the yeai 



For specimen copy, premium list and schedule for game "500" address 

DR. CHAS. WOOD FASSETT, 

Managing Editor, ST. JOSEPH, MO. 



Publisher's Department. 



439 



The combination of the five bromides in Peacock's 
Bromides will give the best possible results, simply because 
the salts employed in its manufacture are extraordinarily 
pure. They are made especially for the product and salts 
of their high purity can not be purchased in the open 
market. 

FRANK G. RYAN ELECTED PRESIDENT OF PARKE, 
DAVIS & CO —The presidency of Parke, Davis & Co., 




Frank G. Ryan. 

left vacant by the death of Theodore D. Buhl, has been 
filled by the advancement of Vice President and Secretary 
Frank G. Ryan — an announcement which will be greeted 
with pleasure by Mr. Ryan's numerous friends throughout 
the country. 

Mr. Ryan was so ideally equipped for this great 
position that he began to march towards it with what is 
now seen to have been almost predestination, as soon as 



The Ralp 
Sanifariu M 

For the Treatment of 

Alcoholism an 
Drug Addictio 

THE method of treatme 
new and very successfu l 
withdrawal of the drug 
attended by any suffering, ar 
cure is complete in a few v. 
time. The treatment is vari< 
cording to the requiremer 
each individual case, and thj 
toration to normal conditi 
hastened by the use of electij 
massage, electric light bath! 
and cold tub and shower V 
vibratory massage, and a li 
well-cooked, digestible die! 

modern, carefully conducted home sanitarium, with spacious surroundings, and attractive < 
and walks. Electro- and Hydro-therapeutic advantages are unexcelled. Trained nurses, hot 
heat, electric lights. Special rates to physicians. For reprints from Medical Journals and full df 
of treatment, address 

DR. B. B. RALPH 5Z9 ^r d Kansas City, W 

^^^^ 





THE MAN 
WHO KNOW 



goes after deer and all big gam 
Marlin. He backs his own sk \ 
Marlin accuracy. 

Marlin Repeaters have origir 
tures shown by no other make. 1 
shoot truer, stand harder service 
absolutely dependable. 

The Model 1893 Marlins hai 
Smokeless Steel" Barrels umi 
smokeless loads. The .32-40 andM 
sizes are also made with the higheJr 
of soft steel barrels for black |f 
The .30-30, .32-40 and .38-55 r< 1 
are the guns for deer and si mill 1 
The Men Who Know have to 1 
of good Marlin stories in our Ex] 
Book — Free — with our catalogijt 
best so far) for 3 stamps postag 

THE MARLIN FIREARM!) 

4 2 Willow St., New Haven, n 



Publisher s Department. 



440 



he joined fortunes with the house seven years ago. He 
left the faculty of the Philadelphia College of Pharmacy in 
the spring of 1900 to become Chief Pharmacist of Paike, 
Davis & Co. At the en.l of three years he had made 
himself so valuable in the councils of the house that he 
was elected to membership on the Board of Directors. A 
year and a half later he was given the important post of 
secretary. Six months later still he was elevated to the 
vice-presidency. And now, after barely another year, he 
is given the very highest position within the gift of the 
house, and one might say without fear of contradiction, 
the greatest and most responsible position yet created in 
the drug trade of the country. 

Born in 1861 in Marcellus Falls, New York, Mr. Ryan 
was educated in the public schools of Elmira, and then 
spent three years in the well-known pharmacy of Brown 
& Dawson in Syracuse. In 1882 he entered the Philadel- 
phia College of Pharmacy and was graduated two years 
later at the age of 23. Two or three years were next 
spent in various Philadelphia stores, and then he was 
made assistant professor of pharmacy in his alma mater. 
In 1898 he was given charge of the course in commercial 
training then established in the P. C. P., and in the 
meantime he had been made lecturer on pharmacy in the 
Woman's Medical College of Philadelphia. In June, 1900, 
Prof. Ryan resigned all his connections in Philadelphia and 
went into the house of Parke, Davis & Co. 

Tne secret of a man's success is never easily analyzed, 
but it may be said of Frank G. Ryan that he represents 
that rare, that ideal combination of technical knowledge 
and experience on the one hand, and business grasp and 
executive ability on the other. These qualities are all but 
incompatible, and he who unites them successfully has 
discovered a philosopher's stone. As president of Parke, 
Davis & Co., Mr. Ryan will be capable of understanding 
thoroughly every scientific detail of the vast business now 
confided to his care, and he will also exhibit that larger 
vision and that greater capacity for administration which 
will carry the house forward to conquests even more 
brilliant than those which have been registered in the past. 



WE SUPPLIED ALL THE CITY INSTITUTIONS WITH DRY GOODS LAST YE/| 

CO. 



WM. BARR GOODS 



Keep the Largest Stock of Goods suitable for 

HOSPITAL PURPOSES 

TO BE FOUND IN ST. LOUIS, 

And Special Terms will be made with all Institutions ordering from them. 

BEDDING MATERIALS OF ALL KINDS, 

UNDERCLOTHING, IN SILK, WOOL AND COTTON, 

LADIES 1 AND CHILDRENS' READY-MADE CLOTH 
FLANNELS AND UPHOLSTERY, 

TABLE AND BED ROOM LINENS, 

SOAPS, NOTIONS AND PERFUME! 
ARE ALL SPECIALTIES AT THE) 

DRY 
GOODS 

NEW BUILDING, 

SIXTH, OLIVE AND LOCUST, .... 

P. S. Write and find out our special terms to Hospitals. 



WM. BARR 



CO': 



ST. LOl 



HALL- BROOKE 

A Licensed Private Hos- 
pital for Mental and 
Nervous Diseases. 



CASES OF ALCOHOLISM 
AND DRUG HABIT. 



OEAUTI FULLY situated on Long 
*^ Island Sound one hour from New 
York. The Grounds consisting of over 
loo acres laid out in walks and drives 
are inviting and retired. The houses are 
equipped with every Modern Appli- 
ance for the treatment and comfort of 
their guests. Patients received from 
any location. Terms Moderate. 

DR. D. W. McFARLAND, 
GREEN'S FARMS. 
CONN. 

Telephone 67-5 Westport Conn 



THE NATIONAL MEDICAL EXCHANGE— Physicians'. Den 
1 and Druggists' Locations and Property bought, 
rented and exchanged. Partnerships arra ! 
Assistants and substitutes provided. Bus 
strictly confidential. Medical, pharmaceutical: 
scientific books supplied at lowest rates. Sen 
cents tor Monthly Bulletin containing te 
locations, and list of books. All inquiries pror 
answered. 
Address, 

H. A. MUMAW, M. D. Elkhart, lnd. 



THE NATIONAL 

Surgical and Dental Chair Exchanj 



r 

i 

\\ 

All kinds of new and second-M 
Chairs, Bought, Sold and Exchanged. 

f^rSEND FOR OUR BARGAIN LIST^fl 

Address with stamp, 

Dr. H. A. MUMAW, Elkhart, lnd. 

LARGE DIVIDENDS 

Are assured stockholders of the SIERR 
PACIFIC SMELTING CO., Sonora, C 
Mexico. 

Easy Payments. Agents Wanted. 
Write for terms. 

Address, 

HENRY MUMAW, Elkhart, lnd. 



Publishers Department . 



441 



Mr. Ryan, accompanied by his daughter Helen, had 
returned from a seven months' trip around the world only 
a week or two before his election to the presidency. His 
main object was to further the intertsts of his house in 
Japan, China and India, but he also visited Manila, 
Ceylon, Egypt, Paris, and London. In Manila an agency 
was established, which adds another to the considerable list 
of foreign branches now conducted by the house. In London, 
on his way back, Mr. Ryan was the guest of honor at two 
banquets attended by men prominent in British pharmacy 
and medicine, and when he landed in New York he was 
greeted at a large reception held at the house of Dr. 
Jokichi Takamine. — Reprinted from the Bulletin of Pharmacy, 
May, 1907. 

DIGESTIVE SECRETIONS.— The stimulation of the 
secretory glands produced by the action of Seng, is a most 
excellent method to restart the process of digestion. 

In those run down and emaciated patients, and after 
lingering diseases, Seng will prove most serviceable in 
building up a normal digestion. It can also be advantage- 
ously used as a vehicle in general treatment when a 
digestive secernent seems desirable and indicated. The 
good results following this form of treatment has been 
very favorably mentioned by many practitioners. 

EVERY PHYSICIAN KNOWS full well the advantages 
to be derived from the use of antikamnia in very many 
diseases, but a number of them are still lacking a 
knowledge of the fact that antikamnia in combination with 
various remedies, has a peculiarly happy effect; particularly 
is this the case when combined with salol. Salol is a 
most valuable remedy in many affections; and its useful- 
ness seems to be enhanced by combining it with anti- 
kamnia. The rheumatoid conditions so often seen in 
various manifestations are wonderfully relieved by the use 
of this combination. After fevers, inflamations, etc., there 
frequently remain various painful and annoying conditions 
which may continue, namely: the severe headaches which 
occur after meningitis, a "stitch in the side" following 



St. Louis Baptist Hospiti 

DR. C. C. MORRIS, Supli 

N. E. COR. GARRISON & FRANKLIN V 
St. Louis, Mo. 




This hospital is open to the medical pro- 
fession generally, and physicians who bring 
their patients here are guaranteed every 
courtesy and the exclusive control of their 
patients. It has a well equipped Bacteriolog- 
ical and Pathological Laboratory under the supervision of a physician well trained I 
branches. Surgical cases are green special attention Address all communications to 




DR. C. C. MORRIS, &j 



Impotency Cases 



It matters not how hopeless; cured or relieved by our combination. 

Helantha Compound. 

Helianthus annuus [sunflower.] Fr. root, bark.H. Australian. Plain 
or with diuretic. 

Has a powerful action upon the blood and entire organism is in- 
dicated in all cases complicated with Malaria, Scrofula, im- 
poverished Blood, Anaemia, etc.. etc., in conjunction with Pil Orient- 
alis (Thompson), will control the most obstinate cases of Impo- 
tency. "Drink Cure" cases, saturated with Strychnine, "Weak 
Men" cases, who tried all the advertised "cures" for impotency, 
and were poisoned with Phosphorus compounds readily yield to 
this treatment. Pil Orientalis (ThompsonJ contains the Extract 
Ambrosia Orientalis. 

The Therapeutical value of this Extract as a powerful Nerve 
ind Brain tonic, and powerful stimulant of the Repro- 
ductive Organs in both Sexes, cannot be over-esti- 
n.ited. It is not an irritant to the organs of generation, but A 
AERATOR and SUPPORTER, and has been known to the native 
Priests of India, Burmah and Ceylon for ages, and has been a harem 
■ n all countries where the Islam has planted the standard of 

Polygamy. 

It is impossible to send free samples to exhibit in Impotency 
cases, requiring several weeks treatment, but we are always willing 
Ho send complimentary packages of each preparation (with formulas 
iod medical testimonials) to physicians who are not acquainted 
witli? their merits. 

us / Hel.mlha Compound, $1.85 per oz. Powder or Capsules. 
Krices^ | p n Orientaiis(Thompson)$1.00 per box. 



THE IMMUNE TABLET COMPANY, 



WASHINGTON, 
D. C. 

AGENTS: 

Meyer Bros. Drug Co., St. Louis. 
Lord, Owen A Co., Chicago. 
Evans-Smith Drug Co., Kansas City. 
Redintfton & Co., San Francisco. 
J. L. L; ons & Co., New Orleans. 



cue 



ENGRAVIM 
CO. 

MEANS -THAT f 
CAN GET HIGH GR/'I 
CUTS FOR ANY KIT 
OF LETTER PRE* 

PRINTING 1 

8 4 MASON 1 
M I LWA U KIE 



Sufl 



HALFTONES ON ZINC OR (' 
WOOD ENGRAVING SfiBrSffi 
ORIGINAL DESIGNERS & Al l! 



! 



Publisher's Department . 



442 



pleurisy, the precordial pain of pericarditis and the painful 
stiffness of the joints which remain after a rheumatic 
attack — all these conditions are relieved by this combination 
called "Antikamnia & Salol Tablets" containing 2}4 grs., 
each of antikamnia and of salol and the dose of which is 
one or two every two or three hours. They are also 
recommended highly in the treatment of cases of both 
acute and chronic cystitis. The pain and burning is 
relieved to a marked degree. Salol neutralizes the uric 
acid and clears up the urine. 

CELER1NA given in doses of from one-half to one 
ounce every four hours, after the removal of alcohol, it is 
claimed, is speedily followed by the most characteristic 
symptoms of improvement. 

ALETRIS CORDIALRIO is an efficient uterine tonic and 
restorative, and is a preparation for which nothing can be 
substituted. 

Increased activity of the muscles of the stomach means 
improved circulation, and this in turn exerts a benefi- 
cial influence on the secretory functions. Thus, excessive 
fermentation and other distressing symptoms are logically 
overcome with actual instead of temporary improvement 
in the whole physical condition. 

GASTRIC IMMOTILITY. — A large proportion of all 
cases of indigestion are the result of weakness of the 
muscular walls of the stomach. Insufficient motility is 
followed by dilatation and this by excessive fermentation 
of the ingested food. Gray's Glycerine Tonic has many 
•commendations in the profession for this condition. 



CACTINA 

PILLETS 



A Cardiac Tonic 
Stimulant 



From Csreus GrandifloralMexicana] 

Each P'dlef containing One One- 
Hundredth of a grain of Cactina 

indicated in functional cardiac 
troubles, such as tachycardia, palpi- 
tation, feebleness; and to sustain the 
heart in chronic and febrile diseases* 
It is not cumulative in its action. 

DOSE- One to Ihr&e Piiiets 
three or four limes a day. 
Put up io bottles of 1 00 piilets 

Fret 53mpies to Phys«si3frs upon request 



Sultan Dru* Co,, St. Louis, Mo. 

Pharmaceutical Chemists 



PEACOCKS 
BROMIDES 



THE BEST FORM 
OF BROMIDES 



Each fluid drachm contains 15 grains 
of the neutral and pure bromides of 
Potassium. Sodium. Ammonium, Cal- 
cium and Lithium. 



In Epilepsy and ail cases demanding 
continued bromide treatment, its 
purity, uniformity and definite thera- 
peutic action, insures the maximum 
bromide results with the minimum 
danger of bromism or nausea. 

DOSE — One to three teaspoonfuls ac- 
cording to the amount of Bromides 
desired. Put up in 1-2 pound bot- 
tles only. Free samples to the 
profession upon request 



Peacock Chemical Co., St. Louis, Mo. 

Pharmaceutical Chemists. 




N 



A Digest! 
Secernei 



A preparation of Panax (G 
which is being successful! 
ployed to stimulate the se 
glands of the alimentary cam 
Indicated in Indigestion, M< 
tion, and all conditions arisin 
a lack of digestive fluids. 

DOSE One or two teaspoon; 
three or more times a 

POT UP IN 10 OZ. BOTTLES 

Free samples to Physicians upon ret 



Sultan Drug Co,, St. Louh 

PHar mac«u!teal Chemists 



CHIONI 



The Hepath 
Stimulan 



Prepared from Chionanthus Virjj 
Expressly for Physicians' Presort*) 



Chionia is a gentle but certain it 
ulant to the hepatic function. 4 u 
overcomes suppressed biliary ! r 
tions. It is particularly indicat< 
the treatment of Biliousness, . 1 
dice, Constipation and allcondin 
caused by hepatic torpor. 

DOSE— One to two teaspoon- 
fnls three times a day. Pot 
up in 1-2 pound bottles only 

Free samples to Physicians upon requf 



Peacock Chemical Co., St. Louis, 



Pharmaceutical Chemists- 



ALIENIST AND NEUROLOGIST 



VOL. XXVIII. ST. LOUIS, NOVEMBER, 1907. No. 4. 



ELECTRICAL SLEEP. 



By C. H. HUGHES, M. D. 

St. Louis. 

FROM Le Monde Medical we abstract the following for 
the information of our readers and for further elucida- 
tion and comment: 

"Dr. Leduc, of Nantes, demonstrated in 1902 the possi- 
bility of sending animals to s eep by means of low tension 
electric currents. At present it looks as if the method 
would very shortly be applicable to human beings seeing 
that Dr. Leduc has tried it on himself with complete suc- 
cess. The method is therefore ot interest so we give the 
details on the subject furnished by Dr. P. C. Petit who 
abstracted the experimental researches carried out by 
Mdlle Robinovitch. 

"The apparatus necessary to send animals to sleep is 
very simple. All we require is a means of obtaining the 
continuous current. Transportable batteries will answer 
the purpose and they bhould be provided with a voltmetre 
and milliamperemetre so that we may know the voltage 
and strength of the current employed. This must admit 
of ready graduation which can be done by means of a 
resistance coil. 

"The current may be either continuous or galvanic. To 
bring about sleep it must be interrupted so as to make it 
discontinuous. Dr. Leduc designed a special interruptor 

(443) 



444 



C. H. Hughes. 



for this purpose giving about 110 makes and breaks per 
second. This is hardly enough. The interruptor is pro- 
vided with an insulating wheel studded with metal studs 
which come into contact with two small metal brushes. 
The current passes when the two brushes come into sim- 
ultaneous contact with the metal studs. One of the 
brushes is movable and may be fixed so as to come into 
contact with a metal stud during a fraction only of the 
time the fixed brush rubs the other stud. The current will 
thus only pass just so long- as the movable brush is in 
contact. 

"Experience shows that it is well to make the movable 
brush contact one-tenth of that of the fixed brush. 

"A simple rule of fractions will make the matter clear. 

"We have mentioned that the current is interrupted 110 
times per second and each second may be subdivided into 
110 parts or 1- 110th of a second. The wheel makes a 
complete revolution in 1- 110th of a second but the movable 
brush being in contact only one-tenth of this period it 
follows that at each turn of the wheel, that is to say at 
each 1-1 10th of a second, the current only passes during 
one-tenth of this 1- 110th of a seccnd. 

"In short we obtain a current which varies in intensity 
passing 110 times a second for one-tenth of this period. 

"The motive power of the apparatus must be furnished 
by accumulators the mains in general being subject to 
minor irregularities which render sleep unequal and 
agitated. 

"Everything having been made ready the animal is 
firmly secured. The parts to receive the current are 
shaved. The negative electrode is placed in contact with 
both thighs. Then the current is turned on. 

"At first the animal displays some uneasiness, it strug- 
gles but after a little tremor "the pain dissappears, the 
animal still tries to raise its head which soon falls back 
on the table, the eyelids close and it looks as if asleep, 
it lies quiet, respiration and the heart beat remain regular.'' 

"This result can be obtained with 6 volts and 1 milli- 



Electrical Sleep. 



445 



ampere and sleep has been maintained as long as eight 
hours and twenty minutes. 

"Observations were made of the various functions 
during the experiment. According to Robinovitch the 
pupils are contracted and the temperature appeared to be 
somewhat lowered. Heart and breathing normal, arterial 
pressure was heightened as long as the sleep lasted. 

"The interest of ascertaining- the effects on man was 
obvious and accordingly Dr. Leduc subjected himself to the 
electrically induced sleep with results worthy of record. 
We give them in his own words: "The first to be 
inhibited were the centres of speech followed by complete 
inhibition of the motor centres. The subject becomes in- 
capable of opposing even very painful stimulation; he is 
unable to communicate any longer with the persons con- 
ducting the the experiment. The limbs, although not in a 
state of complete resolution, present no rigidity; there may 
be a little crying out which has no relationship with any 
painful impression and is apparently due to stimulation of 
the laryngeal muscles. The pulse remained unchanged in 
our experiments. Respiration was slightly hampered. When 
the current reached its maximum intensity 1 could still 
hear what was going on around me, as it were in a dream. 
I was perfectly conscious of my inability to move or to 
communicate with those near me. The sense of touch 
remained active. 1 could feel when I was pinched or 
pricked but the sensations were, so to speak, numbed. 
The most disagreeable sensation was the disassociation and 
gradual disappearance of the senses. This impression was 
like that of nightmare in which one is threatened by some 
imminent danger and can neither move nor utter a cry. 
Nevertheless I regretted all the time that my colleagues 
<3id not push the current to the point of inducing complete 
inhibition. After a preliminary experiment my colleagues, 
thinking that inhibition was complete, cut off the current 
before complete abolition of consciousness. The electromotor 
force was raised to 35 volts with 4 milliamperes intensity 
in the interrupted current. In the two consecutive sittings 
1 remained twenty minutes under the influence of the 



446 



C. H. Hughes. 



current. The awakening was instantaneous and the im- 
mediate feeling was one of comparative well being." 

"In this experiment one electrode of cotton wool steeped 
in salt water and a metal band was fixed to the head and 
the other was applied over the kidney region. 

"The absolute inocuousness of electrically induced sleep 
is confirmed by all writers on the subject so that one day 
electrical narcosis may compete with chloroform and other 
narcoses. Meanwhile Dr. Petit opines that as it is free 
from risk it might be tried in the treatment of mental 
diseases and the "sleep cure" would also be indicated in 
the treatment of agitated lunatics." 

The contributions on the subject of electrical sleep by 
Doctors Leduc and Petit are valuable and interesting and 
the statement of Leduc as to the absolute inocuousness of 
electrically induced sleep being confirmed by all other 
writers on the subject is in accord with the present com- 
mentator's clinical observation. We have successfully man- 
aged insomnia by constant current labile electrizations of 
from eight to twelve and more milliamperemetre power since 
1872, and almost daily — except during our vacations — with- 
out untoward result and with the most satisfactory thera- 
peutic impression, assisted ad interim by suitable somnific 
medication and adequate hepatico-intestinal. 

A clean and clear intestinal tract, a right working 
gastro- duodenal digestion and a general system free from 
excessively irritating fatigue toxines that irritate the brain, 
constitute an important concomitant therapy for the prompt, 
effectual and permanent cure of neurotic insomnia. Many 
cases are so gravely neurasthenic and psychasthenic that 
relief should be immediate, and provision should be made 
in an annex, sleeping contiguous to the physician's room 
or a sleeping apartment very near by, in order to certainly 
save some of the insomniacs who too tardily consult the 
neurologist and alienist. 

Cephalic electrizations, as Petit suggests, ought to be 
tried upon the insane. It ought to be a routine thera- 
peutics in institutions for the insane upon all except the 
somnolent forms of mental derangement and these ought 



Electrical Sleep. 



447 



to be benefitted by static electrizations and the ozonized 
room and Finsen ray, where these instrumentalities do not 
promote or excite de novo delusion. 

The rotation, in this country, for political reasons, of 
medical officers of insane hospitals acts against the welfare 
of the insane by putting over them medical heads who 
are novices in psychiatry, hence the neglect of proper 
psychotherapy, and improper neglect is a more active and 
judicious therapeutic treatment than some of the institu- 
tions afford the patients. 

This evil and wrong against the rights of the insane 
to the best and most skillful chance to recover through ex- 
perience guided, suitable treatment is not so great as 
formerly and it is to be hoped that it will soon cease to 
exist. 

Insomnia in the insane being their most characteristic 
symptom and the chief cause, it would be well if constant 
current daily, afternoon or evening cephalic galvanization 
should become a routine practice in hospitals. It might be 
used as an adjunct or substitute for the tranquilizing bath 
in paroxysms of excitement. At all events it is a valuable 
addition to hypnotherapy, medical or otherwise, in 
psychiatry. 

As early as the beginning of the eighteenth century 
John Wesley, of England, and his brother were relieving 
the pains of lumbago, rheumatism, chorea, sciatica, stomach, 
bowels and head, and incidental to their cure were pro- 
moting sleep by means of static electricity. 

The Wesleys were followed about the middle of that 
century by our own Benjamin Franklin, who was followed 
by L. Cavallo in 1777, the elder Fothergill in 1790, and 
later by Addison, Goding, Bird, Sir William Gill and others 
1837 to 1853, according to Dr. H. N. Chapman's chronol- 
ogy.* Chapman also makes the statement which we have 
to a very great degree verified with adjunctive therapeutics 
since 1870, that by static electricity "insomnia due to 
worry, anxiety or over strain is * * * relieved in 98 



448 



C. H. Hughes. 



per cent of cases * * * with no depressing or disturb- 
ance of stomach." 

The Profession of Wesley's day, however, did not 
approve his methods or means of treatment. It has lived 
to learn more and better of therapeutic electrizations. 



*Is the Induction machine, commonly called static, of any therapeutic 
value?— St. Louis Medical Review, July, 1907. 



SOME PSYCHOLOGICAL STUDIES ON MAN'S 
MORAL EVOLUTION.— NO. III.* 



THE STAR OF BETHLEHEM AND THE MANGER 
IN JUD/EA. 



By ALBERT S. ASHMEAD, M. D., 
New York. 

AS an example of the operation of the Law of Demoli- 
tion, I may refer to race decadence and its danger, 
from the highest birth rate being in the lowest social class. 

Widespread attention has been attracted by the alarm- 
ist opinions expressed on certain vital social problems by 
Sir James Crichton-Browne in his presidential address to 
the sanitary inspectors' congress. He discussed race suicide 
not from the point of view of a falling birth rate, but in 
regard to the close relationship existing between undesira- 
ble social conditions and a high birth rate. 

He quoted startling statistics which proved that in 
districts where there was overcrowding, where there was a 
superabundance of the lowest type of labor, where infant 
mortality was greatest, where there was the most general 
pauperism, where signs of bad environment, like phthisis, 
were most abundant, and where pauper lunatics were most 
numerous, the wives of reproductive ages had the most 
children. Where there was more culture and education, as 
shown by a higher proportion of professional men, where 
there was more comfort and leisure, as shown by a higher 
percentage of domestic servants, there the birth rate was 
lowest. Wives in districts of the least prosperity and 



♦Concluded from August, 1907. 

(449) 



450 



Albert S. Ashmead. 



culture had the largest families and the morally and socially 
lower classes of the community were reproducing them- 
selves with the greatest rapidity. 

We had, he said, to deal with a reduced fertility in 
the more intellectual, the more prosperous, the more thrifty 
and cleanly classes of the community which could not be 
accounted for by a variation in the mean age of possibly 
productive wives. We were confronted by diminished 
fertility, lessened exercise of fertility or deliberate restraint 
of fertility among the elite of our people. Bearing in mind 
that 25 per cent of the married population produced 50 per 
cent, of the next generation and that mental and moral 
traits were not less hereditary than corporeal appearances, 
it was impossible to exaggerate the importance of the 
problems that were raised by the figures he had adduced. 

If we were recruiting our population from the poor and 
mentally and physically feebler stocks of the community at 
a greater rate than from the better and more capable 
stocks, then the gradual deterioration of the race was in- 
evitable. Weeds would accumulate and good grain grow 
scarce, and if the relationship between inferior social status 
and a high birth rate in towns had practically doubled 
during the last fifty years the outlook was gloomy. 

Some hope might be founded on the fact that the 
operative causes of the low birth rate had not yet affected 
the rural population, from which we might hope to draw 
invigorating elements. The relative fertility of women 
living in the country was from 8 to 11 per cent, greater 
than of women living in towns, but urbanization was going 
on at a rate that must rapidly reduce and before long cut 
off the supplies from this source of sound, progressive 
human material. 

The complex problem is connected with racial, indus- 
trial, economical and religious as well as social conditions, 
but in the main the decline must be ascribed either to 
physical degeneration affecting the reproductive power and 
diminishing fecundity or to wilful and systematic prevention 
of ctiild birth. The deterioration of the moral standard 
which the practice of race suicide implied was itself an 



Man's Moral Evolution. 



451 



indication of debility and decay. If race failure was being 
manifested more rapidly in the superior than in the inferior 
varieties of the race, if the reduction in size of families 
had begun at the wrong end of the social scale, then 
national decadence and disaster must be anticipated. 

We must not wrap ourselves up in racial self-conceit, 
he said. We must not forget Greece and Rome and the 
Byzantine Empire. The racial struggle for existence is not 
over and finally decided in our favor. The strategy of the 
struggle and the weapons employed in it are changing 
daily, but it is going on, and if the second Hague confer- 
ence were to succeed to-morrow in abolishing war and 
securing universal disarmament it would only mask the 
conflict and perhaps hasten the catastrophe, and a declining 
birth rate, especially a declining birth rate among the best 
breeds means a diminishing racial resistance. 

The entire press discusses Sir James' warning in a 
much more sober spirit than it has before devoted to the 
subject. Its previous references to the problem have been 
largely confined to remarks in anything but a serious vein 
in regard to President Roosevelt's agitation of the subject. 

I do not exaggerate when I say that Dirt, Disease, 
Deceit and the consequent Discord are fixed prominences 
of Nature against which the human race is pitted, and 
before which never ending contest the vast majority fall, 
beaten to a premature grave. 

The three D's! Nature is content with, indeed in- 
sistent upon the thiee D's, and smiles at the fourth. 

The Wise Men of the East were led by the Star of 
Bethlehem to the manger in Judaea. Is this allegorical, 
like the Serpent in the Garden of Eden? Is it too, a pic- 
ture of man's pre -history, before he had gift of speech? 
All the pictographs and petroglyphs of Patagonia n man 
show that he was speechless when he marked his thoughts 
upon stones or other objects. His expressions in form long 
antedated his linguistics and gutterals. What did they 
mean by this symbol of the Star pointing Man to the 
innocence of the babe? 



452 



Albert S. Ashmead. 



Horace's rustic waited for the river to run down. If 
he could have waited long enough he might have seen its 
last drop roll by. But human nature is always the same. 
If one of those who died when the world was young, 
should return to it now he would not know its cities and 
their customs; but he would know its children and their 
ways; its mothers and their hopes; its lovers and their 
vows; its tears and penalties. He would not know the 
old philosophies by their new names, written in new 
alphabets, and spoken in new tongues; or the old sciences* 
like astronomy, under the modern developments; but he 
would know the human heart and its ideals as he would 
know the midnight sky . and its changeless constellations. 

We are told that our's will one day be a dead planet, 
moving with other dead planets around a cold and darkened 
sun. That will not matter, if love is immortal, and love we 
call God. A wandering angel curious of such things would 
find amid the ruins of our boasted civilization, here and 
there an infant's toy, a marriage ring, a sculptured cross. 
"These are tokens," he would say, "of Eternity, not of 
Time." The tears we shed in sorrow for our dead, and our 
broken hearts, our memories of loved ones gone from us 
forever, lead, like the Star of Bethlehem, to the manger at 
Galilee. What more than this can heaven teach us? 

I admit that consolation is to be found along this path, 
and hard truth of rationalistic philosophy emits no warmth. 
"So mote it be," whatever that means. The escape that 
man reaches from the four D's is in a fifth D — Death. 

Mr. Edward Dobson assumes that "the evolutionary 
doctrine is no longer debatable except in minor phases." 

It is an odd thing that the "evolutionary doctrine" 
(by which is probably meant the hypothesis of genetic 
evolution by natural selection, which may be called the 
Darwinian theory) is popularly supposed to be- finally ac- 
cepted by the scientific world. There could be no graver 
error. Natural selection is at best a working hypothesis 
with a minimum of scientific evidence, and a maximum of 
more or less ingenious, but loose and unscientific reasoning. 



Mans Moral Evolution. 



453 



John Geraid says, speaking of Darwinism, "In spite 
of its great name its success has throughout been popular 
rather than scientific, and as time went on it has lost 
ground among the class most qualified to judge. Evolu- 
tionists there are in plenty, but very few genuine Dar- 
winists, and among these can by ro means be reckoned all 
who adopt the title, for not a few of them, like Romanes 
and Weissman, profess doctrines which cannot be recon- 
ciled with those of Darwin himself." 

Prof. Huxley, an ardent exponent of Darwinism, could 
not unreservedly accept the theory, and a score or more 
of scientific men of the first rank could be named who 
"reject Darwinism altogether, or admit it only with fatal 
reservations." 

That higher forms of organic life have been evolved 
from lower is not disputed, but that all organic life has 
been so developed genetically from substantially the same 
form of germ plasm is very far from an accepted .scientific 
fact. Apart from biological research, which cannot be con- 
clusive, all we have to guide us are the fragmentary 
records of paleontology, which, when critically examined, 
certainly do not help the affirmative very much. 

It is not possible without encroaching seriously upon 
the didactic to show the many obstacles to the acceptance 
of the theory in question, but generally speaking, the 
fossil records of organic life are fertile with evidences an- 
tagonistic to the hypothesis of genetic evolution, while the 
evidence required to support it is conspicuous at every 
turning point, by its absence, and has to be supplied by 
the ingenious imagination of its advocates. As Mr. Fabre 
says, (quoted by Geraid) ; Let us acknowledge that in 
truth we know nothing about anything as far as ultimate 
truths are concerned. Scientifically considered Nature is 
a riddle to which human curiosity can find no answer. 
Hypothesis follows hypothesis, the ruins of theories are 
piled one on another; but truth ever escapes us. To learn 
how to remain in ignorance or innocence' of a baby may 
well be the final lesson of wisdom. 



454 



Albert S. Ashmead. 



Dr. Ravogli, of Cincinnati, in his "Syphilis in Relation j 
to Crime/' says that this disease in acquired and hered- 1 
itary forms has increased crime, and therefore can be con- [ 
sidered as one of the predisposing causes cf criminality. 
He thinks it worthy of consideration, by the deleterious 
action of the virus on the vascular system and on the j 
nervous centers, which serve to explain the degenerations i 
and degradations of the meninges and nerve cells and i 
fibres. Psychoses of specific character are noted occurring 
at an early age by Berkeley, Huebner, Gowers, Shulter, j 
Hjelmann and Heiman, the percentage being 45. Clouston 
suggested (quoted by Ravogli) that "tissues that mature 
slowly are more liable to be affected by hereditary disease." ] 
Growth and energy, with impaired circulation, may do 
harm, because it cannot be rightly distributed and propor- 
tioned. Heredo-syphilitics often show disproportions, or 
immature nervous system, with deep moral alterations, 
so-called degeneracies. Lombroso found the percentage of 
such to be 40. However, Ravogli finds normal types in 
many, where circumstances have impelled to crime, rather 
than congenital impulsion. 

Regarding the effects of syphilis on the brain, Ravogli 
mentions the syphilis epidemic of the 15th century in 
Europe and its suicides due to neuroses and psychoses 
and resulting cerebral affections which were transmitted to 
children and grandchildren. 

At the beginning of the spreading of syphilis in Europe, 
when the best people were affected with it, the best brains, 
crime after crime was committed through Europe. Crimi- 
nality was epidemic. Nobles and rulers and ecclesiastics had 
crazy spells of religious asceticism. Unwarranted murders 
were done. The massacre of the Huguenots in 1572, the 
diabolical scheming on all sides, the butcheries perpetrated 
by the Inquisition, the wars and insurrections of the times 
of Popes Clement VII, Alexander VI and Leo X are cited by 
Ravogli as instances of first generations of heredo-syphilitis. 
Holy massacres, burnings at the stake, tortures, etc., were 
followed by famines, misery, pestilences, and ravaging of 
populations, an outbreak of evil, so to speak, Ravogli 



Man's Moral Evolution. 



455 



refers also to the widespread occurrence to-day of syphilis 
in Russia and the reign of massacre and terror resulting 
therefrom, like the killing of Jews at Kishineff, etc. Where 
syphilis reigns there degeneracy is widespread, he says, 
and he considers the relation between syphilis and crime 
as in direct relation. 

The existence of moral insanity he thinks is often the 
result of syphilitic alteration of the blood vessels, and is 
due, according to some writers he quotes, to meningitis, 
foci of softening, apoplexy or advanced condition of arterio- 
sclerosis. 

The syphilitic degenerates, morally insane, are most 
dangerous criminals. Guiteau is cited as saying: "For 
fifteen days I was inspired; I could not eat nor sleep until 
I executed the deed, after which I slept soundly." 

Lombroso divides criminality into atavic and evolutive 
criminality; the first using violent means, the other keen 
fraud and deception. Ravogli believes that the syphilitic 
and heredo- syphilitic are pre-disposed to the first. 

Ravogli does not excuse the criminal by his syphilitic 
taint, nor does he defend him for limitation of free will. 
He mentions the strange relation existing between syphilis, 
crime and prostitution. Chicago, which has more syphilis 
than New York has also more crime. Syphilis is connected 
too, with pauperism, etc. But then how does Dr. Ravogli 
explain the absence of all these results in excess from the 
population of Japan, where the race has been saturated 
with syphilitic poison 1300 years, while Europe has only 
known it since the 15th century? The violent love of 
murder and war, in Japan, is not due to syphilis at all, 
but to the Brahmanical war- god worship of Krishna. The 
love of bloodshed antedated their syphilitic infection. And 
Japanese degeneracy was not shown "in the Russo-Jap war. 

Dr. Ravogli in closing his paper says, "There, is no 
doubt that crime has been referred to the devil. We see 
the same thing embodied in the old mythology of the story 
of lsis and Osiris." He believes that syphilis, while not 
being the determining cause of crime, is one of the pre- 
disposing factors in the instigation of crime. 



456 



Albert S. Ashmead 



That is to say that it is the cause of all these evils 
cited and that is why criminals have so little free will. 
But that assumes that there is such a thing as free will 
to begin with. 1 doubt that. How about the degeneracy 
of Greece and Rome, and that of England, which is now 
going on? 

It is preposterous for me to suggest that I can con- 
fidently disagree with Dr. Ravogli. But I am able to say 
that I would have to be convinced away from my present 
impressions which cannot instantly accept his conclusions 
as I understand his statement of them; the cause of prac- 
tically all evil. 

But granting this is his declaration, I am not moved 
from my position of attack upon "the sorry scheme of 
things entire," and its Great Author; assuming that an 
Intelligence has ordained all that is — a personal Intelligence. 
If Dr. Ravogli directly or indirectly accuses man or man- 
kind, I must instantly ask: Why did Omnipotent Goodness 
create evil? Why does Omnipotent Goodness permit and 
continue evil? 

If syphilis is a feature of evolution, or an incident of 
operation of an unguided procreative faculty, obeying the 
mandate "increase and multiply" then is my position 
strengthened. There is no Free Will. I recall that a long 
time ago attention was called to venereal disease in the 
Pigeon family, whose members are quite faithful to their 
spouses. And Ancient Man in the Aymaran and Incan 
periods of "civilization" became infected with his first ex- 
perience with the disease by cohabitation, on a mountain 
height, while keeping naturally warm near the female 
llama, whose disease it was. In China, since 1124 B. C. 
syphilis has raged without degeneracy resulting. 

If Dr. Ravogli in any respect finds man derelict, 
except as a waif upon the ocean of Eternity, battered upon 
the shores of Time, 1 must dissent. But perhaps I do not 
read the article and follow Dr. Ravogli step by step from 
start to finish. I am venturesome enough then to say that 
the paper should be read between the lines, for there may 



Mans Moral Evolution. 



457 



be a leaning towards the dogmatic theoiogy, upon "The 
Fall of Man." 

Irregularity shows lack of co-ordination towards an 
end on the part of an individual; discord follows. Nature 
is content with the mediocre, and the higher the excellence, 
the nearer the vanishing point. 

Dr. Ravogli, while he cites in his article, as I said, 
the fact of the widespread occurrence of syphilis in the 
15th century as a reason for the peculiar aberration of 
moral sense, and psychoses among the learned, as cause 
of the subliminal outbreak of such evils as the massacre 
of Bartholomew, and of Huguenots, the Spanish Inquisition, 
etc., and the present epidemic of syphilis throughout Russia 
to explain the massacre of Jews at Kishineff and elsewhere, 
a general letting loose of hell, so to speak, in that empire, 
neglects to mention that a worse outbreak of syphilis in 
Japan did not prevent in the Empire of the Rising Sun, ac- 
ceptance of the most peaceful natural religion which the world 
of man has ever known; that the outbreak of blood-thirst 
and criminality in the Japanese was due to ante-Buddhist 
imbibition of the spirit of Krishna, or god of war devilment, 
which came to them through Brahminism, and which re- 
mained with them even after Buddhist, or worship of earth 
nature had become engrafted on their pagan astronomical 
Shinto faith. An Age of Innocence might well be typified 
allegorically by wise men, or wisdom of the East, being led 
by the worship of astronomical bodies, to the cradle of a 
Christ in the manger ot Judaea, just as syphilis or rever- 
ence for generation or procreative power was expressed by 
a snake or serpent in a Garden of Happiness. Before 
language was known, before the human third cerebral con- 
volution or speech center had evolved, mankind expressed, 
•doubtless, its mental ideas or operations by pictographs on 
stones, or by manual signs not marked on stones, when it 
could only utter gutterals, before such sounds meant words, 
before "the beginning was the Word, and the Word was 
God." 

In Calchaquin symbology, syphilis, the disease of pro- 
creative power, was painted as a serpent eating the male 



458 



Albert S. Ashmead. 



organ of generation. The Serpent and the Tree was a 
well-known distinct worship of procreative power and 
fertility, before the worship of the sun, moon and stars 
(planetary worship) had come into being. How absurd 
then, to attempt to attribute to syphilis the origin of evil. 
In fact, at an early stage of human brain evolution the 
disease was recognized as the Power which had all to do 
with generation. Man was then just beginning to know 
that he had a soul. Among nobles and persons of authority 
those who had the most power over females, the disease 
was certainly rampant. Thus man bowed down to it when 
expressed so that it could be read. It meant power and 
the power was worshipped even when seen on stones. 
Sexual domain was the first kingdom on earth. Men cut 
their foreskins off and sent them to the strongest, to show 
him that they were his subjects. He had dominion over 
their wives. This was the first government of man. 

The outbreak of syphilis in Russia, of course, has a 
cause, and the author of the paper "Syphilis in Relation 
to Crime," should have paused for answer to a question 
that should be auto-propounded. The question is this: 
Has the present outbreak of that disease in Russia any 
connection with a mind and moral degeneracy due to the 
policy of the government in encouraging the drinking of 
spirits for the purpose of increasing its revenues by a 
liquor tax? How long has that been the policy of the 
ruling class? Is it more particularly the policy now than 
at any previous time? 

I believe that autocracy to be capable of any system- 
atic oppression of the people, if thereby they can retain 
their supremacy and their estates; their large holdings of 
land granted centuries ago. 

A degraded peasantry becomes a chatellaine of the 
land; working in the fields, the forests, the mines and at 
the fisheries for mere existence, the money return for the 
produce of their delvings being squandered in the capitals 
of Europe. An army can easily be enrolled, thus, from the 
peasantry; and brought under discipline, freed from drink, 
given secure lodging, sufficient food, warm shelter — little 



Man's Moral Evolution. 



459 



of which they knew at home — they became quite faithful 
defenders of that system which degraded them before they 
wore the uniform and possessed the authority conferred 
upon them by the government. Drink, dirt, disease are 
the great trinity of demolition — and so they ever will be. 
Purity in nature is as purity in politics, described by the 
late Senator Ing-alls, as "an irridescent dream." Even in 
this enlightened land we see hatred of Jews openly ex- 
pressed among our artisans and laboring classes. In France 
likewise. 1 need not extend this. My assignment of the 
particularly stated intent of the writer of the Story of Eden 
grows upon one, especially when connected with examina- 
tions, and the results thereof, of archaeologic remains of 
symbols, in which 1 am engaged. Much of interest for the 
world at large will be presented if the time and probable 
place of the origin of the allegory can reasonably be de- 
termined. 

The allegory is very chaste and pathetic; the pottery 
symbols are quite suggestive. Do we behold a cognate, 
simplv ; or was there a similarity of perception in places 
far removed from each other? If the latter, when relatively 
as to time? If the perception originated in the East, or in 
the West, then, in the absence of long distance navigation, 
was there an island or continental intermediary — in which 
connection the story of Atlantis becomes in presenti worthy 
of consideration. 1 have considerable confidence in the 
tradition handed down by the Egyptian priests, which 
Donelly so enthusiastically and laboriously supports. Nav- 
igation was by the stars, long before it was by the com- 
pass of Phoenicians. 

To return to Dr. Ravogli's paper: About thirteen 
years ago, in conversation upon the Middle Ages, Mr. 
Wilson, now dead, at that time book reviewer for the New 
York World, told me that syphilis was introduced into 
Europe by the Crusaders upon their return from the East. 
1 did not give the matter any further thought, deeming it 
unlikely, as I now deem it. It is recalled to memory by 
the allusion to St. Bartholomew. Hatreds between religions 
needed no especial provocative to bloody conflict in those 



460 



Albert S. Ashmead. 



days. It was an age of blood. The Hebrew — Christian 
God ("vengeance is mine, and I will repay," saith the 
Lord) was carried belligerently against all comers; against 
the Mohammedan rival prophet or intermediary, who was 
not Christ. The Christian form of faith was young and 
self-assertive; was ebullient. Desertion from the elect by 
Luther, aroused, as we all know, the bitterest ranklings. 
This is so established that it surely cannot have escaped 
the attention of Dr. Ravogli. Therefore, why not approach 
his paper cautiously? Possibly he has reserves of statistics, 
or other data, upon which he takes his stand. 

But if he be measureably correct in his conclusions, 
does he feel able to say that he notes anything further 
than a coincidence? If one can definitely present cause 
and result, as that 2 plus 2 make 4, then one has 
knowledge. Unless he can go further than I understand 
that he has gone, he has simply coincidence and not 
cognition. 

The history of the world could easily have been writ- 
ten in the blood shed in war. It seems like a waste of 
time to assign any particular reason for any particular war, 
or local disturbance. In great mind movements the weak- 
minded congenitally, the weak-minded degenerately, are 
always moved to great excesses by the mentality of lead- 
ers, of exhorters. We have seen here in this city within 
a few years, men and women ordinarily sane, strip their 
jewelry from their persons, open their pocketbooks, and 
give their goods to the payment of a church debt, under 
the influence of the speaker hired for the purpose. 

The ecstacy and the murderous fury of religious 
devotees need no recapitulation. But Dr. Ravogli's paper 
he has submitted to the world; he is willing to risk op- 
position of opinion; he may be better fortified than he has 
disclosed. As to Russia, he advances hastily, it would 
seem. 

The Japanese citation I have made, seems to be quite 
in point. Yet Dr. Ravogli might argue in a direction thus: 
The Japanese are successful because of the qualities of 



Man's Moral Evolution. 



461 



their Negro and Malay ancestry yet predominant; and, in 
spite of their syphilized state, they have retained a cairn 
which the New World has not inherited. 

The Japanese appear to me to have relation to a past 
so remote that a deep and wide gulf separates them from 
us and from themselves of to-day; some period in the 
past which would be as the disclosing of a new world to 
us could we know and read it in their traditions and Sagas 
and literature. I seem to look into a strange and grue- 
some scope so unlike anything the world of to-day is 
familiar with that the beings of the then seem to have in- 
habited a fairy land, a land of story of goblins, a land 
directly as to its habitants and their forms of thought, 
directly the reverse of us. A land so far in the past that 
it never can be pictured; it has gone forever, and in those 
people we see scarcely a remnant suggestion. At times 
when I contemplate them I seem to be gazing upon that 
past, a void, a darkness illimitable from which they 
emerge. Strange! Strange! And I knocking them into 
kindling wood. 

From chaos of man's intellectual beginning, has come 
Creation, on several days of his moral evolution: worship 
of generation or power or knowledge of sex, and its rela- 
tion to the family and tribe. "Male and female created 
he them;" worship of the planets, the sun, moon, and 
certain stars, especially those which were useful in guiding 
him in his journey or in navigation. That was long before 
the compass was known to the Phoenicians, long before 
the earliest Chaldean civilization and its origin of circumcision 
as acknowledgment of subjection to a ruler, which antedated 
the Chinese and Aryan. Then came worship of Nature's 
powers, of animals representing mental traits essential to 
man's physical existence, especially the animal attributes 
which would protect him against his enemies of the partic- 
ular time, such as cunning, etc., or the worship of plants 
representative of fertility of soil, family or flock. One 
worship succeeds another as our old world speeds on and 
ever on, and each subserves its purely material purpose 
in man's moral evolution. 



462 



Albert S. Ashmead. 



One who is about worn out with the battering waves 
of the Ocean of Life, who has his life's lines written on 
his soul in letters of black crayon, might say: 

The present is shut out from me. 1 live in the mem- 
ory of the years gone by, — all, all an illusion in youth; a 
delusion for middle age. Every joy is offset by a grief, and 
1 hate God. I remember all the lives connected with me, 
and their dreams, and their and my unsuspiciousness that 
the quicksands of God's treacherous law of things were 
under the feet of all. And all are in the grave. The church 
may inscribe I. H. S. upon its heart. I have put 
upon my heart I. H. G. — see the rendering above. By 
this I will stand to the day of my death. It is not the 
future that I dwell upon — I care nothing for it. The future 
is all provided for by the same inexplicable law that has 
produced the present. I dwell upon the injustices of every 
day, to be observed by all who have passed the exhilara- 
tion of youth — a mild insanity, an unguided FORCE; ob- 
served by all who have not the calm and indifference that 
religion gives. 1 admit the practical value of religion to 
the individual; I insist upon the practical value of the 
Church to the community. I beg that I may not be mis- 
understood. I have heretofore, and many times expressed 
myself fully upon the character of Nature and Nature's 
God (if God there be). I will endeavor to say no more. 

Nature and Nature's Creator are despicable and mur- 
derous beyond human speech to express, and man must 
be sorrowfully patient. 

Even if I read that excerpt from the Chinese literature 
of Yen Tzsee so full of faith, that holy man, who longs 
for the boatman to carry him across the river of Death, 
with silvery voice and in falling cadence each time at the 
words "over the river," which makes the story of the 
pilgrim's progress quite effective, I am not satisfied. For 
Faith is not for me, nor 1 for it. That which is always 
present with me is the difference between the promise and 
the real. We are all misled. You have probably returned 
from a sorrowful mission, perhaps a dear one lies dying, 
whom you have visited for a last time. In such matters 



Man's Moral Evolution. 



463 



words are worthless, so I speak not when I meet you. It 
is the state of mind that ignores all words. For one it is 
faith; for another it is resignation. Each produces a calm, 
perhaps a simulation of indifference. Faith has voice. 
Resignation is mute. Faith drinks of the "Blood of the 
Lamb" at the altar. Resignation sometimes "Looks upon 
the wine when it is red." The former is higher than the 
latter, but the imagery of each is low. Neither Faith nor 
Resignation changes one whit the ordained law of distress, 
modifies not one whit the sentence of decay. The Wisdom 
that has built the heavens and moulded the earth has 
made life more to be dreaded than death. 



A MISTAKEN DIAGNOSIS OF DEMENTIA 
SENILIS. 



A Medico-Legal Record of the Last Will and Testament of Ben. H. 
Johnson, deceased; Cause of Clara M. Laswell vs. 
John Hungate, Executor, in the Hancock Illinois 
Circuit Court. 

Reported With Comments by C. H. Hughes, M. D. 
The Hypothetical Case. 

The following hypothetical case embraces all the essential facts 
and conjectures as to the mental state of Ben H. Johnson, deceased. 
The description in this case was amended and corrected by the attor- 
neys of both sides aided by the court until the biography was ac- 
ceptable to all parties concerned in the suit and submitted to each and 
all of the opinion witnesses. 

A SSUMING the following to be true: That Benjamin F. 

Johnson was born about 1825; that his parents were 
healthy people and of sound mind and memory; that when 
he grew to manhood he was about five feet and six or 
eight inches in height, rather spare built, weighed about 
one hundred and forty or fifty pounds, and had brown hair 
and gray eyes, and was of a swarthy complexion; that he 
was in his early manhood a blacksmith; that about 1849 or 
1850 he went to California and there made some 16,000.00 
or $7,000.00 principally by buying at Sacramento, San 
Francisco and elsewhere, sheep and other animals and 
taking them up into the mountains to mining camps and 
selling them; that in a few years he returned to Illinois; 
that about 1862 or 1863 he purchased a farm in the vicinity 
of what is now known as Colusa, in Hancock County, 
Illinois, and moved on to the same about 1863 or 1864; 

(464) 



A Mistaken Diagnosis. 



465 



that thereafter he continued to reside upon this farm until 
about 1885 or 1886, except that during this time he made 
a visit to California and was gone about one year, and at 
another time removed for a short time to the City of La 
Harpe; that about 1886, he removed from this farm to the 
City of La Harpe; where he continued to live until his 
death; that he was married three times; that his first wife 
died; that for his second wife he married a widow woman 
by the name of Rapallee, about 1859, and lived with her 
as his wife until about 1873, when this wife was divorced 
from him; that he married for his third wife, Phoebe A. 
Green; that he was a good business man, above the 
average man in that respect; that he could and did, up to 
within about one or two years of his death, make his own 
contracts, attend to all of his business affairs in person, 
bought lands from time to time in large quantities, loaned 
money, collected rents and otherwise carried on in person 
extensive business interests, wrote deeds, mortgages, leases, 
notes, checks and numerous other papers and contracts in 
his own hand, and that these show good penmanship and 
good business ideas and methods; that he accumulated 
money, lands and other property and left about twenty- 
three hundred acres of land in Hancock County, Illinois, 
when he died, a considerable amount of which was acquired 
after alleged will was made, besides town property in La 
Harpe and personal property; that he was a well read man; 
was well posted in current events and could and did talk 
about them at most times, until within a year or two of 
his death, coherently with his friends; that he could and did, 
on numerous occasions, discuss politics, history, religion and 
many other subjects well; that he could and did play chess 
frequently; that he was positive in his opinions; of a ner- 
vous temperament, was quick spoken and quick in forming 
judgment, and was economical in his habits; that he always 
kept whiskey on his premises and drank of the same 
frequently, but moderately and was never intoxicated; that 
he was a profane man and used oaths frequently and used 
the words "by hell" in common conversation; that about 
1860 there was born to him and his second wife, a daughter, 



466 



C. H. Hughes. 



who was named Clara M., who was put in school and 
educated by her father and with whom he kept up a 
correspondence by letter while in school and after her mar- 
riage; that in a letter to this daughter dated March 21, 
1873, he wrote "Received a letter from Hot Springs, 
Arkansas, and they said it would not do for me to go 
there as they (the springs) are injurious to heart disease; 
that in another letter to his daughter dated January 8, 1897, 
he said "1 have to be careful of that place in my side 
where the pleurisy came near killing me in 1845. It has 
bothered me more or less ever since. It will stop I presume 
before many years, but whether I will get a sound organ- 
ization or not in the next life, if there is one, I will not 
find out until 1 arrive;" that about 1864, while being as- 
sisted by a neighbor in running an underground ditch on 
his farm, a controversy arose as to the proper manner of 
running the ditch and after it was run his way he found, after 
the machine had gone some distance that no cross ditch (as 
he supposed) had been made and became angry and greatly 
excited and commenced to swing his hat and jump up and 
down and swear and talk rapidly and excitedly and, among 
other things, said "God Almighty, God our Heavenly Father, 
Oh Jehovah! what a damned fool 1 was, for not taking your 
advice;" that on another occasion prior to 1870, while he 
was having some hedge plants set out by some boys a 
dog dug some of them up, whereupon he became greatly 
excited and threw his hat upon the ground, cursed and 
swore and stamped upon his hat and said it's the dogs 
nature to do it; that while living on this farm on or about 
November 18, 1870, while bringing a load of about 1,000 
feet of wet lumber on a wagon from Dallas City to his 
home, the wag-on was overturned and the lumber fell upon 
his limbs and the lower part of his body, pinning him down 
and holding him fast for one hour or more until he, by his 
cries for help, attracted the attention of a neighbor one- 
half mile away; that the lumber falling upon him crushed 
one of his hips; that from the effect of such injury he was 
confined to his bed for about four months; that during said 
time he underwent, on account of such injuries, great pain 



A Mistaken Diagnosis. 



467 



and suffering; that after leaving his bed he was unable to 
walk except with the. use of two crutches for about one 
year; that thereafter he was unable to walk except with 
the aid of one crutch and a cane for about one year; that 
from that time as long as he lived he was lame and unable 
to walk except with the use of a cane; that he said on 
several occasions after being injured by the lumber falling 
©n him that he suffered intense pain at times in his injured 
hip and limb; that while he was in be 1 with this injury 
he had no use of the injured limb; and it had to be moved 
around by attendants; that the other limb was numb and 
had to be rubbed; that he said electric batteries were 
applied to his injured hip and limb; that after that, though 
he was able to walk on crutches for a time, the foot of his 
injured limb hung so that his toes would drag; that about 
1872 or 1873, he said on one occasion when speaking of this 
injury, that he didn't think he would ever recover again 
from that injury, that he did'nt rest well of a night on ac- 
count of the pain he had in his hip, and that he had a pain 
at the base of the brain, and that he would never be Mr. 
Johnson again; that he visited Horn's drug store at Dallas 
City frequently between 1874 or 1875 and the time he, the 
said Johnson moved to La Harpe in 1886, and that he 
spoke of his condition to John Horn, the druggist, on most 
of these visits to the drug store; that he said during one 
of these visits that his nervous system was shocked, that 
he wasn't gaining any strength, that he did'nt get any 
rest, and wanted to know if there was anything the said 
Horn could do for him; that he said to the said Horn he 
wanted something to bathe his neck, such as he, the said 
Horn, had recommended to him before, and that he had a 
pain in his hip and back of his head and neck, and that 
he could'nt sleep well, that he got liniment from the said 
Horn, that he asked the said Horn for it and the said Horn 
put it up for him; that he always wore in cold weather a 
shawl instead of an overcoat; that he gave as the reason 
for wearing a shawl that he could'nt handle himself since 
he had that injury, that he could throw on a shawl, that 
it pained him under his shoulder-blade and back of his 



468 



C. H. Hughes. 



neck in giving the twist to put on an overcoat; that after 
said injury he was more passionate and more easily fretted 
and worried, got mad quicker and was more easily excited 
and that this increased as he grew older; that at the time 
of receiving: this injury he was living with his second wife;, 
that she was a widow at the time he married her about 
ten years before, and had by a former husband three 
children, two boys and a daughter; that after their mar- 
riage he accused one of these boys with having forged his 
name to notes and became very angry at him; that about 
1873, this wife procured a divorce from him, and that their 
property interests were determined by arbitration, where- 
upon she got about 55,000.00 or #6,000.00 of his estate; 
that he entertained a bitter hatred for her; that he often 
spoke of this wife and her sons as the Rapallees, and 
from the time of this divorce he would frequently talk 
about them, and when doing so frequently became angry,, 
excited and agitated and often gesticulated in a forceful, 
and violent manner, and would frequently stamp his cane 
up and down, and whirl it round and over his head and 
cursed and swore and called her a God damned bitch, and 
said that he had lived in hell for fourteen years and often in 
the same connection swore that he would never leave his 
property to the God damned Rapallees; that after their 
separation he spoke of this wife repeatedly in an angry 
and excited manner, abusing and cursing her; that on some 
of these occasions he would have a staring wild look; that 
this language and conduct was usually commenced by him 
suddenly and without anything occurring or being said to 
bring the subject up; that when his daughter, Clara, was 
about twelve or thirteen years of age she attended a church 
service at a church within about one-half mile of her 
father's home, which had been erected on the corner of his. 
farm, and when the minister conducting the services gave 
an invitation to persons to come forward to the altar she,, 
with about twenty other persons, went forward, and while 
properly conducting herself at the altar her father came 
down the aisle of the church and in the presence of the 
congregation, took his daughter by the arm and took her 



A Mistaken Diagnosis. 



46* 



out of the church without saying a word, and said to the 
minister the next day when speaking about the matter, 
"1 suppose you thought 1 acted very rudely last night;'* 
that he did not want his daughter to do that, that he 
thought she was too young and did not think she under- 
stood what she was doing, and that he did not want her 
to be a backslider; that on one occasion when his daughter 
Clara, was about fifteen years of age she and a step- 
daughter of the said Johnson, a Miss Green, a daughter of 
his then wife by a former husband, who was about fourteen 
years of age, got into some altercation, when Clara slapped 
the face of Miss Green a little; that thereupon said Johnson 
got a buggy whip and undertook to whip his daughter, 
Clara, with the same and chased her all around over the 
house and up stairs and down stairs and when she got into 
a room and fastened the door he burst the door down in 
order to get into the room where she was and struck her 
three or four blows with the buggy whip and continued 
his efforts to use the whip upon her until his wife, the 
mother of the said Miss Green, interposed and induced him 
to desist; that about 1874 or 1875 when it was suggested 
to Johnson that it would be the proper thing for him to 
endow some institution of learning after he had made pro- 
vision for his family that his money might live after him 
he said in substance he was not in favor of co-education 
and that a good many young men did not appreciate a free 
education and some of the institutions of learning and that 
he had no patience with a man that did not try to do 
anything for himself; that about 1880 or 1882, after a 
congregation had assembled one evening for religious wor- 
ship in said church, situated on the corner of Johnson's 
farm, and after some of the people had tied their teams to 
Johnson's hedge fence near the church, and while the 
services were in progress he walked into the church and 
standing in the aisle stated to the minister he would like 
to speak a word and the opportunity being given him he 
said to the congregation in a loud voice, "By Jesus Christ 
if you don't take your horses from my fence 1 will cut 
every damned one of them loose;" that some time between 



470 



C. H. Hutfies. 



1870 and 1886, his step-daughter and her husband with 
whom he was on friendly terms, were at his home. 

At the same time there was visiting with the family 
his wife's brother and his wife's nephew; that one evening 
in January or February his step-daughter's husband and 
his wife's brother went to Colusa station, about one-half 
mile away, and his step-daughter spoke of herself and the 
nephew going to a neighbor's to have some music, about 
one-half mile distant; that it was a cloudy evening, and 
dark, threatening rain, but not raining- or storming; that 
Johnson then grew angry and said to his step-daughter, 
"Anybody would be a God damned fool to go out a night 
like this," whereupon she said, "you can express your 
words in a different way;" that whereupon he called her 
a God damned fool two or three times and spoke of her 
husband and uncle who had gone to Colusa and said in 
substance that they were God damned fools for going to 
Colusa such a bad night, thereupon the step-daughter said 
he had said enough, and then Johnson said to her, "There 
is the door and you can get out of here;" that the step- 
daughter then went across the road and stayed all night, 
she and her husband, with a neighbor; that in all of 
his correspondence with his daughter said Johnson ad- 
dressed her as "My dear child" or "My Child;" that all 
of his letters to her were kind in tone and composition, 
and that in no letter did he criticise her or find fault with 
her; that in a letter to his daughter dated February 19, 
1882, before her marriage, he wrote among other things, 
"My lameness troubles me a good deal and my right 
shoulder that I had crushed years ago by being thrown 
from a horse is troubling me a good deal this winter. I 
guess all the infirmities a person ever had in this life visit 
one in a body when he gets old." 

In the spring of the year 1882, while his daughter 
was in school he spoke kindly of her and said he was 
going to make her a present of a gold watch and other 
jewelry, for which he said he had paid #400. 00, and said 
he was going the next day to take the train and take the 
jewelry to her, stating at the time she was away at school; 



A Mistaken Diagnosis. 



471 



that on the day following he appeared at the railroad sta- 
tion and stated that he was going to take the train and take 
the jewelry to his daughter; that he exhibited a box and 
said it was in there; that while waiting for the train he re- 
ceived his mail and opened a letter, that before reading the 
letter he was calm and normal; that upon reading it he 
became very angry and called the attention of a by-stander, 
a Mr. Bailey, an acquaintance, to the letter and pointed to 
a part of the letter and said see that; that the portion of 
the letter pointed to read, "dear Mamma you see 1 spell 
Mamma with a capital *M' and papa with a small 'p,' '* 
and where she referred to Papa it was in very small letters, 
he pointed to another part of the letter and said "See 
that," which part of the letter to which he pointed to read 
"I am working papa for this jewelry;" that he then began 
striking the letter with his cane and said "it is the Rap- 
palees that put her up to it;" said he knew it was his 
daughter who had written the letter; that it was her 
handwriting, that before reading the letter he was calm 
and collected and in his normal condition, but that after 
reading the letter became greatly excited and agitated, 
struck the letter with his cane furiously, sprang up and 
down, pounded with his cane, that he cursed and swore 
in a high key and refused to be quieted; that he so con- 
tinued for about one-half hour, at the end of which time 
he was weak and considerably exhausted and was assisted 
into a wagon and taken home; that during this time and 
while being taken home he stated he was going to write a 
will at once and cut his daughter off without any of his 
property; that on arriving home he requested the party 
who had assisted him to and into the wagon and taken 
him home to come into the house and witness his will, 
saying that he was going to write a will at once and cut 
his daughter out; that on March 8, 1882, he wrote a 
friendly letter to one Bishop, giving his consent for him 
to marry his daughter Clara, and expressed therein a 
wish for their happiness and that they may never have 
cause for regret; that on March 20, 1882, he wrote a 
friendly letter to his daughter, Clara, addressing her as "My 



472 



C. H. Hughes. 



Child;" and telling her therein that he had met Mr. 
Bishop; that he acted straightforward and manly and 
furnished proper testimonials of his standing, and says t« 
her, among other things, "I wrote to him that whenever 
you and him wish to unite your destinies you had my 
consent and saying in this letter further "1 will furnish 
you a bed and some bedding;" that he purchased her 
wedding clothes; that on August 20, 1882, he again wrote 
his daughter a letter in which he addressed her "My dear 
Child" and said among other things, "I have had some 
changes in my past life that give it variety. At present it 
is on the humdrum order. Had a lively change a few 
mornings ago in a bad fall that has crippled my right 
shoulder badly that, with my lame left hip, takes me diag- 
onally;" that in another letter to his daughter dated October 
8, 1882, he said "About three weeks ago I had one of the 
bad spells 1 am liable to have and went flat and I don't 
rally as I would like. A number of years ago two surgeons 
pronounced sentence on me that I was liable to drop dead 
at any instant and unless I took extra care of myself I 
was sure to;" that in a letter to his daughter dated Janu- 
ary 4, 1886, he said "I am getting somewhat discouraged 
with myself. 1 am so completely worthless and worn out. 
Probably 1 have had my share, if not of toil and 
exposure and now it seems as every crush and strain 1 
have had in the past comes back to annoy me. When I 
sit down it seems as though I need a charge of dynamite 
under the chair to raise me;" that in another letter to his 
daughter dated March 21, 1886, he said "Now that I am 
crippled and have neither nerve or hope it annoys me;" 
that in a letter to his daughter dated June or July 27, 
1886, he says "I have not passed a day or night since I 
got crushed without suffering pain in my hip and leg, 
sometimes very severe;" that in another letter to his 
daughter dated November 18, 1886, he said "This is the 
anniversary of my crush on November 18, 1870. Since 
that night I have not passed a day or night without suffer- 
ing pain in that hip and crushed limb, sometimes the 
pains seem too hard to bear;" that between September, 1888 



A Mistaken Diagnosis. 



47Z 



and 1890 or 1891, he got Judge George Edmunds, a lawyer 
of Carthage, to write a will for him and told him he 
wanted to give his daughter for life the Southeast quarter 
of Section 26, in Township 7 North, Range 7 West, Han- 
cock County, Illinois, and the balance of his property, or 
the big end of it, he wanted to go to the public schools of 
the city of La Harpe; that thereupon said Edmunds pro- 
tested and told him he ought to give his daughter more; 
that he refused to do so and gave as his reason that his 
daughter was married to a man by the name of Bishop; 
that they had one son who was four or five years old; that 
the boy was sickly and would probably not live to be a 
man, and that his daughter would likely not have any 
more children, and if he gave his daughter anything more 
than what would keep her during life that it would then 
go to the Rappalees upon her death and that he objected 
to the Rappalees getting any of his property; that on 
November 16, 1890, he wrote a letter to his daughter ad- 
dressing her as "My Child," wherein he acknowledges the 
receipt of a photograph of Roy and says, "Accept thanks. 
Hoy* looks quite healthy. Am glad to see the improvement." 

■ In 1888 or 1889 he had a difficulty on the streets of 
La Harpe, with a minister, in which the minister called him 
a reprobate and shook his fist under his nose; that the 
same day or the next day said Johnson went into a store 
in La Harpe and conversed with one Huston about the 
difficulty he had had with the minister and said he called 
me a damned old reprobate, reprobate, reprobate, what is 
a reprobate? and pounded with his cane and said "I wish 
I had killed him. I would have if I could;" that he was 
at the time very white and his eyes had a stary look and 
that said Johnson returned some four or five times to this 
store within the next ten days thereafter and on each oc- 
cccasion used the same language in substance and looked 
and acted about the same on each occasion; that in a 
letter to his daughter dated March 25, 1890, he said, "Had 
1 not thought somewhat of the future I should now be in 
a bad fix, old and crippled, not a ple